Tumor Lysis Syndrome.

Tarek Barbar, Insara Jaffer Sathick

Journal: Advances in chronic kidney disease 2022;28(5):438-446.e1

PMID: 35190110

Full Text on Elsevier Science View on PubMed

Abstract

Tumor lysis syndrome (TLS) is an oncologic emergency due to massive tumor cell lysis with the release of large amounts of potassium, phosphate, and nucleic acids into the systemic circulation. Clinical presentation is characterized by hyperkalemia, hyperphosphatemia, hyperuricemia, and hypocalcemia. Acute kidney injury due to tumor lysis is potentiated by the precipitation of uric acid and calcium phosphate as well as renal vasoconstriction. Early recognition of tumor lysis can help prevent cardiac arrhythmias, seizures, and death. Management includes intravenous hydration to maintain urine flow, medications targeting hyperuricemia including rasburicase and allopurinol and in severe cases renal replacement therapy may be required.

Address: Renal Service, Department of Medicine, Memorial Sloan Kettering Cancer Center; Weill Cornell Medical College, New York, NY.; Renal Service, Department of Medicine, Memorial Sloan Kettering Cancer Center; Weill Cornell Medical College, New York, NY. Electronic address: [email protected].

DOI: 10.1053/j.ackd.2021.09.007

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MeSH Terms: Allopurinol, Humans, Hyperphosphatemia, Hyperuricemia, Renal Replacement Therapy, Tumor Lysis Syndrome, Urate Oxidase