Effect of Cilastatin on Cisplatin-Induced Nephrotoxicity in Patients Undergoing Hyperthermic Intraperitoneal Chemotherapy
| Autor: | Consuelo Jimenez, María Iluminada Canal-Alonso, Pilar Cabrerizo-Torrente, Alberto Lázaro, Susana Gago-Quiroga, L. Gonzalez-Bayon, Mercedes Power, María Dolores Ginel-Feito, Natividad Palencia-García, Wenceslao Vasquez-Jimenez, Pablo Lozano-Lominchar, María Ángeles González-Nicolás, Matilde Zaballos |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
Imipenem Nefrología y urología medicine.medical_treatment 030232 urology & nephrology cisplatin Hyperthermic Intraperitoneal Chemotherapy Kidney lcsh:Chemistry 0302 clinical medicine polycyclic compounds Prospective Studies Renal Insufficiency lcsh:QH301-705.5 Spectroscopy Peritoneal Neoplasms cilastatin nephroprotection nephrotoxicity Imipenem/cilastatin General Medicine Middle Aged Combined Modality Therapy Computer Science Applications imipenem/cilastatin 030220 oncology & carcinogenesis Creatinine Hyperthermic intraperitoneal chemotherapy Female medicine.drug Adult medicine.medical_specialty Urology Renal function Antineoplastic Agents Catalysis Article Nephrotoxicity Inorganic Chemistry 03 medical and health sciences Surgical prophylaxis Toxicología medicine Humans Physical and Theoretical Chemistry Molecular Biology Aged Retrospective Studies Chemotherapy Cilastatin HIPEC business.industry Organic Chemistry lcsh:Biology (General) lcsh:QD1-999 business |
| Zdroj: | International Journal of Molecular Sciences Volume 22 Issue 3 International Journal of Molecular Sciences, Vol 22, Iss 1239, p 1239 (2021) E-Prints Complutense. Archivo Institucional de la UCM instname |
| Popis: | Cisplatin is one of the most widely used chemotherapeutic agents in oncology, although its nephrotoxicity limits application and dosage. We present the results of a clinical study on prophylaxis of cisplatin-induced nephrotoxicity in patients with peritoneal carcinomatosis undergoing cytoreduction and hyperthermic intraperitoneal intraoperative chemotherapy (HIPEC-cisplatin). Prophylaxis was with imipenem/cilastatin. Cilastatin is a selective inhibitor of renal dehydropeptidase I in the proximal renal tubule cells that can reduce the nephrotoxicity of cisplatin. Unfortunately, cilastatin is not currently marketed alone, and can only be administered in combination with imipenem. The study has a retrospective part that serves as a control (n = 99 patients receiving standard surgical prophylaxis) and a prospective part with imipenem/cilastatin prophylaxis corresponding to the study group (n = 85 patients). In both groups, we collected specific data on preoperative risk factors of renal damage, fluid management, hemodynamic control, and urine volume during surgery (including the hyperthermic chemotherapy perfusion), as well as data on hemodynamic and renal function during the first seven days after surgery. The main finding of the study is that cilastatin may exert a nephroprotective effect in patients with peritoneal carcinomatosis undergoing cytoreduction and hyperthermic intraperitoneal cisplatin perfusion. Creatinine values remained lower than in the control group (ANOVA test, p = 0.037). This translates into easier management of these patients in the postoperative period, with significantly shorter intensive care unit (ICU) and hospital stay. |
| Databáze: | OpenAIRE |
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