Side-Effects on the Renal function of Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy

Area of Science:

• Oncology
• Nephrology
• Surgical Critical Care

Background:

• Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) poses risks for acute kidney injury (AKI) due to intra-abdominal pressure, heat stress, and drug toxicity.
• AKI is a significant concern in patients undergoing these complex procedures.

Purpose of the Study:

• To investigate the incidence and risk factors of AKI in patients post-CRS and HIPEC.
• To evaluate the association between AKI and mortality in this patient population.

Main Methods:

• Retrospective analysis of 123 patients admitted to the ICU after CRS and HIPEC over 129 months.
• Data collected included demographics, severity of illness (SOFA score), laboratory results (renal function, electrolytes), cancer type, HIPEC details, fluid balance, and outcomes (ICU/hospital stay, mortality).

Main Results:

• The incidence of AKI was low at 4.9%.
• Risk factors for AKI included ovarian cancer, doxorubicin use, positive fluid balance, higher SOFA scores, and mechanical ventilation.
• Electrolyte disorders (hypocalcemia, hypokalemia) were highly prevalent (95.8%), but AKI was not associated with increased mortality.

Conclusions:

• The study found a low incidence of AKI after CRS and HIPEC, with electrolyte disturbances being frequent.
• Factors like cancer type (non-mitomycin regimens) and positive fluid balance during surgery may increase AKI risk.
• Despite poorer clinical status in AKI patients, mortality rates were similar to non-AKI patients.