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

Background: Acute kidney injury (AKI) is a frequent complication in patients undergo-ing cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) due to a combination of several factors: increased intra-abdominal pressure, heat stress and drug tox-icity. Methods: Patients admitted to Intensive Care Unit after CRS and HIPEC during 129 months. Data recorded were: demographic characteristics; severity of illness, haematology and basic chemistry panels (renal function and electrolytes), type of cancer and extension, HIPEC drug and temperature, fluid balance, ICU and hospital stay and mortality. Results: 123 patients were included, only 4.9% developed AKI. AKI was more frequent on patients with ovarian cancer or in those who received doxorubicina as intraperitoneal chemotherapy; also, among those who had higher positive fluid balance during surgery, had higher SOFA or were under mechanical ventilation at ICU admission. There were not differences in mortality according to the development of AKI. Electrolyte disorders appeared in 95.8% of the patients, mainly hypocalcemia and hypokalemia. Conclusion: In our study, the incidence of AKI has been low. The presence of hydroelectrolytic alterations and polyuria was very frequent. The type of cancer, no mitomycin-based regimens and positive fluid balance during surgery were factors that suggest increased risk of AKI. However, although patients with AKI were clinically worse it was not associated with higher mortality.