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Korean J Crit Care Med > Volume 17(1); 2002 > Article
Korean Journal of Critical Care Medicine 2002;17(1): 19-24.
원저 : 복강 내 온열 관류 요법 시 동반 투여한 화학요법제가 수술 후 신장 기능에 미치는 영향
최종호, 김은성
가톨릭대학교 의과대학 마취과학교실
The Effects of Chemotherapeutic Agents on Renal Function during Continuous Hyperthermic Peritoneal Perfusion
Jong Ho Choi, Eun Sung Kim
Department of Anesthesiology, College of Medicine, The Catholic University of Korea, Seoul, Korea. jchoi@catholic.ac.kr
ABSTRACT
BACKGROUND: Continuous hyperthermic peritoneal perfusion (CHPP) has been introduced to improve the survival of the advanced cancer patients. It is a technique that allows uniform delivery of cytotoxic agents and heat to the peritoneal surface. However CHPP - induced acute changes of body temperature and intraabdominal pressure could produce various abnormal physiologic responses, especially hypoperfusion and hypoxia. These factors may further contribute to the renal dysfunction. Moreover, transperitoneal absorption of drugs resulting in systemic toxicity and certain anticancer drugs have an inherent nephrotoxicity. The aim of the present study was to investigate the effect of anticancer drugs on the kidney in the ovarian cancer patients after CHPP. METHODS: CHPP with anticancer agents in warm saline was performed in 54 patients with cancer of the ovary at temperature 47 degrees C for 90 minutes under general anesthesia. Forty nine patients were given carboplatin and 5 patients were received cisplatin intraperitoneally at an equi-toxic dose. To clarify the effect of cisplatin and carboplatin on the kidney, serum creatinine and blood urea nitrogen (BUN) were measured before anesthesia, 1, 3 and 7th day after surgery in both agents. RESULTS: There were no significant changes of creatinine level on 1, 3 and 7 days postoperatively compared to preoperative creatinine in carboplatin patients. In carboplatin patients, postoperative BUN levels were decreased significantly on 1 and 3 days, but they were within normal range. BUN level of postoperative 7 day showed no significant change. In cisplatin patient, there was insignificant increase of BUN and creatinine levels on 1, 3 and 7 days postoperatively. CONCLUSIONS: These results suggest that carboplatin did not suppress renal function until 7 days after CHPP. Cisplatin markedly increased the creatinine and BUN until 7 days postoperatively, but there was no statistical significance.
Key Words: Hyperthermia: continuous hyperthermic peritoneal perfusion; Kidney: nephrotoxicity; Pharmacology: carboplatin; cisplatin
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