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

IF 3 3区 医学 Q2 ONCOLOGY
International Journal of Hyperthermia Pub Date : 2024-01-01 Epub Date: 2024-02-11 DOI:10.1080/02656736.2024.2304250
Chih-Chung Cheng, Hung-Chieh Yeh, Pei-Wen Su, Chien-Lin Ho, Sheng-Chi Chang
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引用次数: 0

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.

顺铂腹腔热化疗中慢性肾病的风险因素。
目的:顺铂是腹膜恶性肿瘤热腹腔化疗(HIPEC)的常用药物。急性肾损伤(AKI)被认为是 HIPEC 联合细胞减毒手术(CRS)后的常见并发症。然而,HIPEC术后慢性肾脏疾病(CKD)却很少见,而且研究较少。本研究旨在调查顺铂为基础的HIPEC术后CKD的发生率,并分析相关风险因素:自2016年1月至2021年8月,共55例接受CRS和顺铂为基础的HIPEC治疗的腹膜癌患者被回顾性地分为有CKD和无CKD两组。研究人员收集了患者的人口统计学特征、合并症、手术、术后管理和并发症等信息,以评估与顺铂类 HIPEC 相关的 CKD 风险因素。进行了单变量和多变量分析,以确认不同变量与 CKD 发生之间的相关性:结果:在 55 例患者中,有 24 例(43.6%)发生了 AKI,其中有 17 例(70.8%)进展为 CKD。多变量回归分析发现,术中使用帕瑞昔布(Odds Ratio (OR) = 4.39)和术中最高温度> 38.5°C(OR = 6.40)是顺铂类 HIPEC 相关 CKD 发生的主要风险因素。虽然II型糖尿病和术中并发症是顺铂HIPEC术后发生AKI的独立风险因素,但在CKD分析中并未显示:结论:在基于顺铂的HIPEC术中使用帕瑞昔布是导致术后CKD的重要风险因素。临床医生在 HIPEC 手术期间应谨慎使用帕瑞昔布。此外,将术中体温维持在 38.5°C 以下可能是降低发生 CKD 风险的关键。本研究强调了识别和预防特定风险因素对改善顺铂 HIPEC 患者长期肾脏预后的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
5.90
自引率
12.90%
发文量
153
审稿时长
6-12 weeks
期刊介绍: The International Journal of Hyperthermia
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