Sodium Thiosulfate Reduces Acute Kidney Injury in Patients Undergoing Cytoreductive Surgery Plus Hyperthermic Intraperitoneal Chemotherapy with Cisplatin: A Single-Center Observational Study

Background: Cytoreductive surgery (CRS) in combination with hyperthermic intraperitoneal chemotherapy (HIPEC) represents a multimodal treatment concept for patients with peritoneal surface malignancies. The use of intraperitoneal cisplatin (CDDP) is associated with a risk of acute kidney injury (AKI). The aim of this study is to evaluate the protective effect of perioperative sodium thiosulfate (STS) administration on kidney function in patients undergoing CRS and CDDP-based HIPEC. Patients and Methods: We retrospectively analyzed clinical data of all patients who underwent CRS and CDDP-based HIPEC at our hospital between March 2017 and August 2020. Patients were stratified according to the use of sodium thiosulfate (STS vs. no STS). We compared kidney function and clinical outcome parameters between both groups and determined risk factors for postoperative AKI on univariate and multivariate analysis. AKI was classified according to acute kidney injury network (AKIN) criteria. Results: Of 238 patients who underwent CRS and CDDP-based HIPEC, 46 patients received STS and 192 patients did not. There were no significant differences in baseline characteristics. In patients who received STS, a lower incidence (6.5% vs. 30.7%; p = 0.001) and severity of AKI (p = 0.009) were observed. On multivariate analysis, the use of STS (OR 0.089, p = 0.001) remained an independent kidney-protective factor, while arterial hypertension (OR 5.283, p < 0.001) and elevated preoperative urea serum level (OR 5.278, p = 0.032) were predictors for postoperative AKI. Conclusions: The present data suggest that STS protects patients from AKI caused by CRS and CDDP-based HIPEC. Further prospective studies are needed to validate the benefit of STS among kidney-protective strategies

Bio-solution for global sand crisis and sustainable organic agriculture in desert states

Sand is an important component of many everyday items, and currently sand is the second most extracted resource on earth after water, but it is not sustainable: we are running out of sand! The black market is booming, and the sand mafia is mining sand at any price. Desert sand is unusable, even Dubai must import it. The smooth surface and iron impurities prevent its industrial use. In this study, bacteria in the bioleaching test attacked the surface of the mineral grains and dissolved impurities including iron through organic acids. Furthermore, the liquid residue containing dissolved iron, organic acids and bacteria stimulated the growth plant what can be a valuable biofertilizer and biostimulant for organic agriculture. Desert states have fertility problems. Despite this, Qatar, for example, is aiming for self-sufficiency in vegetables “in five years”. Results showed that bioleaching combined with magnetic separation resulted in iron removal of 73.23%. The sand after treatment can be suitable to produce clear flat glass, coloured container glass, insulating glass fibres or ceramics. The integrated technology based ecological study revealed overall as utilization potential of the desert sand and the liquid residue could support glass and food production in desert states