Cargando…
Effect of Cilastatin on Cisplatin-Induced Nephrotoxicity in Patients Undergoing Hyperthermic Intraperitoneal Chemotherapy
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 a...
Autores principales: | , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7865672/ https://www.ncbi.nlm.nih.gov/pubmed/33513824 http://dx.doi.org/10.3390/ijms22031239 |
_version_ | 1783647901477502976 |
---|---|
author | Zaballos, Matilde Power, Mercedes Canal-Alonso, María Iluminada González-Nicolás, María Ángeles Vasquez-Jimenez, Wenceslao Lozano-Lominchar, Pablo Cabrerizo-Torrente, Pilar Palencia-García, Natividad Gago-Quiroga, Susana Ginel-Feito, María Dolores Jiménez, Consuelo Lázaro, Alberto González-Bayón, Luis |
author_facet | Zaballos, Matilde Power, Mercedes Canal-Alonso, María Iluminada González-Nicolás, María Ángeles Vasquez-Jimenez, Wenceslao Lozano-Lominchar, Pablo Cabrerizo-Torrente, Pilar Palencia-García, Natividad Gago-Quiroga, Susana Ginel-Feito, María Dolores Jiménez, Consuelo Lázaro, Alberto González-Bayón, Luis |
author_sort | Zaballos, Matilde |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-7865672 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-78656722021-02-07 Effect of Cilastatin on Cisplatin-Induced Nephrotoxicity in Patients Undergoing Hyperthermic Intraperitoneal Chemotherapy Zaballos, Matilde Power, Mercedes Canal-Alonso, María Iluminada González-Nicolás, María Ángeles Vasquez-Jimenez, Wenceslao Lozano-Lominchar, Pablo Cabrerizo-Torrente, Pilar Palencia-García, Natividad Gago-Quiroga, Susana Ginel-Feito, María Dolores Jiménez, Consuelo Lázaro, Alberto González-Bayón, Luis Int J Mol Sci Article 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. MDPI 2021-01-27 /pmc/articles/PMC7865672/ /pubmed/33513824 http://dx.doi.org/10.3390/ijms22031239 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Zaballos, Matilde Power, Mercedes Canal-Alonso, María Iluminada González-Nicolás, María Ángeles Vasquez-Jimenez, Wenceslao Lozano-Lominchar, Pablo Cabrerizo-Torrente, Pilar Palencia-García, Natividad Gago-Quiroga, Susana Ginel-Feito, María Dolores Jiménez, Consuelo Lázaro, Alberto González-Bayón, Luis Effect of Cilastatin on Cisplatin-Induced Nephrotoxicity in Patients Undergoing Hyperthermic Intraperitoneal Chemotherapy |
title | Effect of Cilastatin on Cisplatin-Induced Nephrotoxicity in Patients Undergoing Hyperthermic Intraperitoneal Chemotherapy |
title_full | Effect of Cilastatin on Cisplatin-Induced Nephrotoxicity in Patients Undergoing Hyperthermic Intraperitoneal Chemotherapy |
title_fullStr | Effect of Cilastatin on Cisplatin-Induced Nephrotoxicity in Patients Undergoing Hyperthermic Intraperitoneal Chemotherapy |
title_full_unstemmed | Effect of Cilastatin on Cisplatin-Induced Nephrotoxicity in Patients Undergoing Hyperthermic Intraperitoneal Chemotherapy |
title_short | Effect of Cilastatin on Cisplatin-Induced Nephrotoxicity in Patients Undergoing Hyperthermic Intraperitoneal Chemotherapy |
title_sort | effect of cilastatin on cisplatin-induced nephrotoxicity in patients undergoing hyperthermic intraperitoneal chemotherapy |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7865672/ https://www.ncbi.nlm.nih.gov/pubmed/33513824 http://dx.doi.org/10.3390/ijms22031239 |
work_keys_str_mv | AT zaballosmatilde effectofcilastatinoncisplatininducednephrotoxicityinpatientsundergoinghyperthermicintraperitonealchemotherapy AT powermercedes effectofcilastatinoncisplatininducednephrotoxicityinpatientsundergoinghyperthermicintraperitonealchemotherapy AT canalalonsomariailuminada effectofcilastatinoncisplatininducednephrotoxicityinpatientsundergoinghyperthermicintraperitonealchemotherapy AT gonzaleznicolasmariaangeles effectofcilastatinoncisplatininducednephrotoxicityinpatientsundergoinghyperthermicintraperitonealchemotherapy AT vasquezjimenezwenceslao effectofcilastatinoncisplatininducednephrotoxicityinpatientsundergoinghyperthermicintraperitonealchemotherapy AT lozanolomincharpablo effectofcilastatinoncisplatininducednephrotoxicityinpatientsundergoinghyperthermicintraperitonealchemotherapy AT cabrerizotorrentepilar effectofcilastatinoncisplatininducednephrotoxicityinpatientsundergoinghyperthermicintraperitonealchemotherapy AT palenciagarcianatividad effectofcilastatinoncisplatininducednephrotoxicityinpatientsundergoinghyperthermicintraperitonealchemotherapy AT gagoquirogasusana effectofcilastatinoncisplatininducednephrotoxicityinpatientsundergoinghyperthermicintraperitonealchemotherapy AT ginelfeitomariadolores effectofcilastatinoncisplatininducednephrotoxicityinpatientsundergoinghyperthermicintraperitonealchemotherapy AT jimenezconsuelo effectofcilastatinoncisplatininducednephrotoxicityinpatientsundergoinghyperthermicintraperitonealchemotherapy AT lazaroalberto effectofcilastatinoncisplatininducednephrotoxicityinpatientsundergoinghyperthermicintraperitonealchemotherapy AT gonzalezbayonluis effectofcilastatinoncisplatininducednephrotoxicityinpatientsundergoinghyperthermicintraperitonealchemotherapy |