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The incidence of cisplatin nephrotoxicity post hyperthermic intraperitoneal chemotherapy (HIPEC) and cytoreductive surgery
Authors:Hakeam A Hakeam  Ayman Azzam  Ashraf Nadeem  Tarek Amin
Institution:1. Pharmaceutical Care Division, King Faisal Specialist Hospital &2. Research Centre, College of Pharmacy, King Saud University RiyadhSaudi Arabia;3. Surgical Oncology, King Faisal Oncology Center, King Faisal Specialist Hospital &4. Research Centre RiyadhSaudi Arabia;5. Faculty of Medicine Alexandria UniversityEgypt;6. Critical Care Medicine, King Faisal Specialist Hospital &
Abstract:Background: Cisplatin is commonly used in hyperthermic intraperitoneal chemotherapy (HIPEC) for the management of peritoneal carcinomatosis. Little is known about the nephrotoxic effects of cisplatin use in HIPEC. Objectives: To report the incidence of nephrotoxicity post-HIPEC using cisplatin 50?mg/m2 plus doxorubicin 15?mg/m2. The incidence of hypomagnesemia was investigated as a secondary endpoint. Methods: This is a retrospective study evaluating patients who received cisplatin with doxorubicin during HIPEC. RIFLE classification was used to assess the development of nephrotoxicity. Variables, such as comorbidities and nephrotoxic medications were obtained. Renal function parameters were also collected, including serum creatinine levels and serum magnesium levels at baseline and at days 3, 7 and 30 after HIPEC. Perioperative urine output (UO) was also recorded. Results: Fifty-three patients were identified. Based on the RIFLE classification, two patients (3.7%) developed acute kidney injury (AKI) following HIPEC with cisplatin. One patient met criteria for renal failure and progressed to chronic renal failure. The other patient had renal injury. Comparable mean creatinine levels were observed at baseline and on day 30 following HIPEC (p?>?0.05). The incidence of hypomagnesemia increased to 24.5% by day 7 (p?=?0.041) and 30.1% by day 30 (p?p?Conclusion: Nephrotoxicity can complicate HIPEC with cisplatin therapy and that permanent renal dysfunction may rarely occur. More attention to be directed toward monitoring magnesium levels after cisplatin use with HIPEC.
Keywords:Chemotherapy  cisplatin  HIPEC  nephrotoxicity  RIFLE
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