Acute renal disease in patients with ovarian peritoneal carcinomatosis treated with cytoreduction and HIPEC: the influence of surgery and the cytostatic agent used

Background The main objective of this study was to evaluate the differences between cisplatin and paclitaxel in the development of postoperative renal toxicity, using as a reference the RIFLE (Risk, Injury, Insufficiency, Loss, and End-stage renal function) and AKIN (Acute Kidney Injury Network) cri...

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Published in:Langenbeck's archives of surgery 2021-11, Vol.406 (7), p.2449-2456
Main Authors: Gómez-Ruiz, Álvaro Jesús, González-Gil, Alida, Gil, José, Alconchel, Felipe, Navarro-Barrios, Álvaro, Gil-Gómez, Elena, Martínez, Jerónimo, Nieto, Aníbal, García-Palenciano, Carlos, Cascales-Campos, Pedro Antonio
Format: Article
Language:English
Subjects:
Abdominal Surgery
Cardiac Surgery
General Surgery
Medicine
Medicine & Public Health
Original Article
Thoracic Surgery
Traumatic Surgery
Vascular Surgery
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Summary:Background The main objective of this study was to evaluate the differences between cisplatin and paclitaxel in the development of postoperative renal toxicity, using as a reference the RIFLE (Risk, Injury, Insufficiency, Loss, and End-stage renal function) and AKIN (Acute Kidney Injury Network) criteria in patients with primary or recurrent ovarian cancer with peritoneal dissemination treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC). Methods One hundred fifty-two patients who were treated between December 2007 and June 2017 were analyzed. Results Patients who received previous platinum-based chemotherapy had higher baseline creatinine levels than those who had not ( p  = 0.05). A total of 11 (7.2%) and 4 (2.6%) patients developed an acute renal dysfunction (ARD) during the postoperative period of cytoreduction and HIPEC according to the RIFLE and AKI criteria respectively. RIFLE detects a higher rate of ARD due to different parameters such as GFR (7.2% versus 2.6%, p  = 0.016). Performing ostomy ( p  = 0.007; OR: 39.320; 95% CI = 2.74–56.13) and using of cisplatin during HIPEC treatment ( p  = 0.017; OR = 13.619; 95% IC = 1.600–25.95) were factors independently related to a higher rate of ARD. Conclusion ARD has a multifactorial origin. Cisplatin was associated with the development of a higher rate of ARD than paclitaxel. Diagnosis of ARD did not correlate with worse survival figures.
ISSN:1435-2443
1435-2451
DOI:10.1007/s00423-021-02279-6