Tubular dysfunction after peritonectomy and chemohyperthermic treatment with cisplatin

Gaetano La Manna, Salvatore Virzí, Marcello Deraco, Irene Capelli, Alma Accorsi, Vittorio Dalmastri, Giorgia Comai, Serena Bonomi, Antonio Grassi, Saverio Selva, Giorgio Feliciangeli, Maria Scolari, Sergio Stefoni

Research output: Contribution to journalArticlepeer-review

Abstract

Peritoneal carcinomatosis has always been regarded as a contraindication in traditional cancer surgery treatment; however, good results have been reported by using new combined medical-surgical loco-regional techniques. Peritonectomy and chemohyperthermic perfusion with cisplatinum (CIIP) seem to play a central role in obtaining a better survival rate than with the traditional procedures, even though there is a cisplatinum nephrotoxic effect. The aim of this study was to investigate entity and type of renal injury after CIIP. Forty-two patients (12 males and 30 females) with recurrent or primary peritoneal carcinomatosis who underwent peritonectomy and cytoreductive surgery with hyperthermic intraperitoneal chemotherapy with cisplatin were enrolled. A significant worsening in renal function was observed on the third post-operative day and this condition then persisted for three months. A reduction in estimated-Glomerular Filtration Rate (e-GFR) and an alteration in the albumin:creatinine ratio proved tubular injury. On the third post-operative day after cisplatinum administration, a high toxicity peak was found following platinum free fraction excretion. Proximal tubular injury was confirmed even at the three month analysis. A significant correlation between the total protein reduction rate and the decrease in renal function was established. In relation to that, the platinum free fraction could increase because of a binding protein shortage and the nephrotoxic effect could be enhanced due to platinum accumulation within the post-operative period. This finding suggests that the higher the protein reduction is, the lower the e-GFR determination is at three months.

Original languageEnglish
Pages (from-to)703-706
Number of pages4
JournalIn Vivo
Volume20
Issue number6 A
Publication statusPublished - Nov 2006

Keywords

  • Acute renal failure
  • Carcinomatosis
  • Chemohyperthermic treatment
  • Cisplatin
  • Peritonectomy
  • Tubular dysfunction

ASJC Scopus subject areas

  • Medicine(all)

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