TY - JOUR
T1 - Identification of risk factors associated with postoperative acute kidney injury after cytoreductive surgery with hyperthermic intraperitoneal chemotherapy
T2 - a retrospective study
AU - Cata, Juan P.
AU - Zavala, Acsa M.
AU - Van Meter, Antoinette
AU - Williams, Uduak U.
AU - Soliz, Jose
AU - Hernandez, Mike
AU - Owusu-Agyemang, Pascal
N1 - Publisher Copyright:
© 2017, © 2017 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2018/7/4
Y1 - 2018/7/4
N2 - Background: Acute kidney injury (AKI) is a postoperative complication associated with significant morbidity and mortality. The incidence and risks factors for AKI after cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) have not been fully studied. The purpose of this study was to identify perioperative risk factors predictive of AKI after CRS-HIPEC. Methods: This retrospective study collected demographic, tumour-related, intraoperative and postoperative data from 475 patients who underwent CRS-HIPECs. AKI was defined using the acute kidney injury network criteria and calculated on postoperative days 1, 2, 3, 7 and day of hospital discharge. We conducted univariate and multivariate analyses to assess the association between variables of interest and AKI. A p value of <0.05 was considered statistically significant. Results: The incidence of AKI was 21.3%. The multivariate analysis identified six predictor factors independently associated with the development of AKI (OR: [95%CI]); age: 1.16 (1.05–1.29, p < 0.005), BMI (overweight: 1.97 [1.00–3.88], p = 0.05) and obesity: 2.88 (1.47–5.63), p < 0.002)), preoperative pregabalin: 3.04 (1.71–5.39, p < 0.037), platinum-based infusion: 3.04 (1.71–5.39, p < 0.001) and EBL: 1.77 (1.27–2.47, p < 0.001). Splenectomy had a protective effect (OR: 0.44 (0.25–0.76, p < 0.003). Conclusions: Our study demonstrates that the incidence of AKI is high. While other studies have reported that AKI is associated with platinum-based infusion, age and obesity, we report for the first time a negative association between pregabalin use and AKI. More studies are needed to confirm our results.
AB - Background: Acute kidney injury (AKI) is a postoperative complication associated with significant morbidity and mortality. The incidence and risks factors for AKI after cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) have not been fully studied. The purpose of this study was to identify perioperative risk factors predictive of AKI after CRS-HIPEC. Methods: This retrospective study collected demographic, tumour-related, intraoperative and postoperative data from 475 patients who underwent CRS-HIPECs. AKI was defined using the acute kidney injury network criteria and calculated on postoperative days 1, 2, 3, 7 and day of hospital discharge. We conducted univariate and multivariate analyses to assess the association between variables of interest and AKI. A p value of <0.05 was considered statistically significant. Results: The incidence of AKI was 21.3%. The multivariate analysis identified six predictor factors independently associated with the development of AKI (OR: [95%CI]); age: 1.16 (1.05–1.29, p < 0.005), BMI (overweight: 1.97 [1.00–3.88], p = 0.05) and obesity: 2.88 (1.47–5.63), p < 0.002)), preoperative pregabalin: 3.04 (1.71–5.39, p < 0.037), platinum-based infusion: 3.04 (1.71–5.39, p < 0.001) and EBL: 1.77 (1.27–2.47, p < 0.001). Splenectomy had a protective effect (OR: 0.44 (0.25–0.76, p < 0.003). Conclusions: Our study demonstrates that the incidence of AKI is high. While other studies have reported that AKI is associated with platinum-based infusion, age and obesity, we report for the first time a negative association between pregabalin use and AKI. More studies are needed to confirm our results.
KW - Kidney injury
KW - chemotherapy
KW - hyperthermia
KW - surgery
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U2 - 10.1080/02656736.2017.1368096
DO - 10.1080/02656736.2017.1368096
M3 - Article
C2 - 28812384
AN - SCOPUS:85028563511
SN - 0265-6736
VL - 34
SP - 538
EP - 544
JO - International Journal of Hyperthermia
JF - International Journal of Hyperthermia
IS - 5
ER -