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Risk factors of chronic kidney disease in cisplatin-based hyperthermia intraperitoneal chemotherapy

Authors :
Chih-Chung Cheng
Hung-Chieh Yeh
Pei-Wen Su
Chien-Lin Ho
Sheng-Chi Chang
Source :
International Journal of Hyperthermia, Vol 41, Iss 1 (2024)
Publication Year :
2024
Publisher :
Taylor & Francis Group, 2024.

Abstract

Purpose Cisplatin is commonly prescribed in hyperthermic intraperitoneal chemotherapy (HIPEC) for peritoneal malignancy. Acute kidney injury (AKI) is regarded as a common complication after HIPEC combined with cytoreductive surgery (CRS). However, post-HIPEC chronic kidney disease (CKD) is scarce and less investigated. This study aims to investigate the incidence of CKD following cisplatin-based HIPEC and to analyse the associated risk factors.Materials and Methods From January 2016 to August 2021, a total of 55 patients treated with CRS and cisplatin-based HIPEC for peritoneal carcinomatosis were categorized retrospectively into groups, with and without CKD. Demographics, comorbidity, surgery, postoperative management, and complications were collected to evaluate risk factors for cisplatin-based HIPEC-related CKD. Univariate and multivariate analyses were conducted to confirm the correlation between different variables and CKD occurrence.Results Of the 55 patients, 24 (43.6%) patients developed AKI and 17 (70.8%) patients of these AKI patients progressed to CKD. Multivariate regression analysis identified intraoperative use of parecoxib (Odds Ratio (OR) = 4.39) and intraoperative maximum temperature > 38.5°C (OR = 6.40) as major risk factors for cisplatin-based HIPEC-related CKD occurrence. Though type II diabetes mellitus and intraoperative complications were the independent risk factors of AKI following cisplatin-based HIPEC, but they were not shown in CKD analysis.Conclusion Intraoperative use of parecoxib during cisplatin-based HIPEC emerged as a significant risk factor for postoperative CKD. Clinicians should exercise caution in prescribing parecoxib during HIPEC procedures. Additionally, maintaining intraoperative body temperature below 38.5°C might be crucial to mitigate the risk of CKD development. This study underscores the importance of identifying and preventing specific risk factors to improve long-term renal outcomes in patients undergoing cisplatin-based HIPEC.

Details

Language :
English
ISSN :
02656736 and 14645157
Volume :
41
Issue :
1
Database :
Directory of Open Access Journals
Journal :
International Journal of Hyperthermia
Publication Type :
Academic Journal
Accession number :
edsdoj.1a778063d76c40549d0c2d6143e1e877
Document Type :
article
Full Text :
https://doi.org/10.1080/02656736.2024.2304250