Hyperthermic intraperitoneal chemotherapy with cisplatin: Amifostine prevents acute severe renal impairment

Identification of risk factors associated with postoperative acute kidney injury after cytoreductive surgery with hyperthermic intraperitoneal chemotherapy: a retrospective study

“…Our study also demonstrated that the development of AKI was significantly associated with the type of chemotherapy infused, EBL, administration of pregabalin, BMI and age. Patients who received cisplatin or oxaliplatin as the HIPEC agent had a higher risk of AKI compared to those who received mitomycin C. While this finding is similar to what has been described in previous studies [11,20], the extent to which this association may be wholly ascribed to the direct nephrotoxic effects of the platinum agents has been the subject of controversy [8,21]. The basis of the disagreement is that plasma levels of HIPEC agents including cisplatin have been demonstrated to be well below the cytotoxic threshold and may therefore not be sufficient to explain the nephrotoxicity observed [22].…”

“…The incidence of AKI in this large cohort of patients who had undergone CRS-HIPEC was 21%. Reported rates of AKI after CRS-HIPEC have ranged between 2% and 22% [9][10][11][12][13]17,18]. For example, Hamilton et al found that 7.1% of the 42 patients in their study developed acute renal failure after CRS-HIPEC.…”

“…To date, the actual incidence and risk factors associated with the development of postoperative AKI after CRS-HIPEC surgery remain poorly studied. The reported incidence ranges between 2% and 22%; however, most of the studies reporting this complication had limited sample sizes and have used different systems to define renal insufficiency [9][10][11][12]. Hence, we conducted a retrospective study with the aim of identifying risk factors of AKI in adult patients who underwent HIPEC surgery in a large tertiary cancer care centre.…”

Platinum agents and mitomycin C-specific complications in cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC)

“…In the paper from MD Anderson Cancer Centre, patients received HIPEC with cisplatin after CRS for sarcomatosis, with 25% of patients developing ARI, but this was reduced to 0% when pre-operative hydration at greater than maintenance rate and intravenous sodium thiosulphate (STS) was administered simultaneously with HIPEC [25]. In a separate paper by the French group, Amifostine was administered to reduce the incidence of ARI, and seemed to show benefit in reducing ARI in patients receiving HIPEC with cisplatin [26].…”

Regimens of Intraperitoneal Chemotherapy for Peritoneal Carcinomatosis from Colorectal Cancer

“…HIPEC with cisplatin has an associated risk of renal dysfunction during treatment. Bouhadjari et al investigated the effect of amifostine, which is free radical scavenger, for patients treated with HIPEC using oxaliplatin (49). Thirtyone patients receiving amifostine had a lower risk for renal dysfunction (which is defined as a creatinine clearance rate lower than 30 ml/min), compared to 21 patients not receiving amifostine (13% vs. 33%, respectively).…”