An Unusual Outcome after Hyperthermic Intraperitoneal Chemotherapy (HIPEC): AKI in a Patient Treated with HIPEC with Cisplatin

Introduction: HIPEC stands at the forefront of innovative therapeutic approaches for managing select abdominal malignancies, revolutionizing the landscape of cancer treatment by combining an aggressive cytoreductive surgery with localized delivery of heated chemotherapy agents directly into the peritoneal cavity. Concerns regarding nephrotoxicity, particularly associated with the use of cisplatin, warrant attention. HIPEC has gained challenges such as excessive cost and the need for highly qualified personnel. In presenting this case, we exemplify the complexities of HIPEC-induced nephrotoxicity, highlighting the need for its timely recognition and management and the importance to consider and investigate post HIPEC CKD Case Description: A 57-year-old Mexican female was hospitalized at the ICU after undergoing cytoreductive surgery and cisplatin-based HIPEC for peritoneal recurrence of ovarian cancer. Follow-up labs performed the next day revealed increased CR, urea, and BUN, suggesting impaired kidney function. Pre-op lab results did not indicate any type of risk factors or kidney injury before surgery. Renal function and diuresis continued to deteriorate over the following days. On the 4th day after surgery, presenting with anuria and unable to reverse her condition, the patient underwent an initial session of hemodialysis and has been dependent ever since with more than 5 months after surgery Discussion: To our knowledge post HIPEC CKD information is scarce. AKI Post HIPEC has been noted as an important challenge due to the nephrotoxic properties of cisplatin but progression to CKD remains unclear. Nevertheless, the development of HIPEC-induced AKI with the possibility of CKD should not deter its use but rather emphasize the importance of raising awareness of searching for preventive strategies in aims of enhancing its effectiveness in improving patient clinical outcomes