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Original Articles

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

, , ORCID Icon, , , & show all
Pages 538-544 | Received 27 May 2017, Accepted 13 Aug 2017, Published online: 29 Aug 2017
 

Abstract

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.

Disclosure statement

The authors have not conflict of interest to disclose.

Additional information

Funding

This work was partially supported by a Cancer Center Support Grant (CCSG) from the University of Texas MD Anderson Cancer Center, Houston, TX, USA.

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