Incidence, risk factors, and outcomes of the transition of HIPEC-induced acute kidney injury to acute kidney disease: a retrospective study

Abstract

Background

Acute kidney injury (AKI) is recognized as a common complication following cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC). Characterized by prolonged renal function impairment, acute kidney disease (AKD) is associated with a higher risk of chronic kidney disease (CKD) and mortality.

Methods

From January 2018 to December 2021, 158 patients undergoing CRS-HIPEC were retrospectively reviewed. Patients were separated into non-AKI, AKI, and AKD cohorts. Laboratory parameters and perioperative features were gathered to evaluate risk factors for both HIPEC-induced AKI and AKD, with the 90-day prognosis of AKD patients.

Results

AKI developed in 21.5% of patients undergoing CRS-HIPEC, while 13.3% progressed to AKD. The multivariate analysis identified that ascites, GRAN%, estimated glomerular filtration rate (eGFR), and intraoperative (IO) hypotension duration were associated with the development of HIPEC-induced AKI. Higher uric acid, lessened eGFR, and prolonged IO hypotension duration were more predominant in patients proceeding with AKD. The AKD cohort presented a higher risk of 30 days of in-hospital mortality (14.3%) and CKD progression (42.8%).

Conclusions

Our study reveals a high incidence of AKI and AKI-to-AKD transition. Early identification of risk factors for HIPEC-induced AKD would assist clinicians in taking measures to mitigate the incidence.

Keywords:

• HIPEC
• AKI
• AKD
• CKD
• renal function

Acknowledgements

This work was preprinted at Research Square [https://doi.org/10.21203/rs.3.rs-1820140/v1]. The citation was Yunwei Lu, Xiujuan Zhao, Yingjiang Ye, et al. Incidence, risk factors, and outcomes of transition of HIPEC-induced acute kidney injury to acute kidney disease: a retrospective study, 15 July 2022, PREPRINT (Version 1).

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The research has received support from the Beijing Natural Science Foundation with a grant number of [7222199], the National Natural Science Foundation of China with a grant number of [81971808], and Peking University People’s Hospital Scientific Research Development Funds with a grant number of [RDGS2023-07].