Effect of Urine-guided Hydration on Acute Kidney Injury After CRS-HIPEC

Summary

Acute renal injury (AKI) is a common complication after cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC), and is associated with worse outcomes. Available evidences show that maintaining intraoperative urine output ≥ 200 ml/h by fluid and furosemide administration may reduce the incidence of AKI in patients undergoing cardiopulmonary bypass. The investigators hypothesize that, for patients undergoing CRS-HIPEC, intraoperative urine-volume guided hydration may also reduce the incidence of postoperative AKI.

Conditions

• Cytoreductive Surgery
• Hyperthermic Intraperitoneal Chemotherapy
• Hydration
• Diuresis
• Acute Kidney Injury
• Postoperative Complications

Interventions

PROCEDURE

Urine-guided hydration

The target is to maintain urine output at 200 ml/h (3 ml/kg/h) or higher by intravenous injection/infusion of furosemide throughout surgery. That is, a loading dose of 20 mg is injected at the beginning of surgery; if urine output does not reach the target value, furosemide will be continuously infused at 10 mg/h until the end of surgery, with a cumulative dose not exceeding 250 mg. Intravenous rehydration is performed to balance urine output and to maintain the SVV ≤10%.

PROCEDURE

Routine hydration

The target is to maintain urine output at 0.5 ml/kg/h or higher according to routine practice. That is, furosemide is only administered when clinically necessary or at discretion of responsible anesthesiologists; intravenous rehydration is performed to maintain the SVV ≤10%.

DRUG

Forced administration of furosemide

Forced administration of furosemide

DRUG

Routine administration of furosemide

Routine administration of furosemide

Sponsors & Collaborators

• Aerospace Center Hospital

  collaborator OTHER

• Peking University First Hospital

  lead OTHER

Principal Investigators

• Dong-Xin Wang, MD, PhD · Peking University First Hospital, Beijing, CHINA

Study Design

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

TRIPLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2023-07-24

Primary Completion

2024-07-19

Completion

2025-02-04

Countries

• China

Study Locations