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2021-05-27

Does tumor lysis syndrome cause metabolic acidosis?

Does tumor lysis syndrome cause metabolic acidosis?

Decreased urine output, fluid overload, edema, cardiac arrhythmia, and/or seizures may accompany later stages of clinical tumor lysis syndrome due to renal insufficiency, metabolic acidosis. Occasionally, patients may also report syncope.

Why is tumor lysis syndrome an emergency?

TLS is an oncologic emergency characterized by the development of hyperuricemia, AKI, and electrolyte disturbances that can be life threatening. It is crucial to identify patients at high risk for this syndrome for prompt detection of those patients with TLS suitable to receive early treatment.

What is tumor lysis syndrome?

Tumor lysis syndrome (TLS) is a condition that occurs when a large number of cancer cells die within a short period, releasing their contents in to the blood.

Which chemotherapy drugs cause tumor lysis syndrome?

Other potential risk factors include:

  • large tumor size.
  • poor kidney function.
  • fast-growing tumors.
  • certain chemotherapy medications, including cisplatin, cytarabine, etoposide, and paclitaxel.

Which treatment strategy increases the risk of developing tumor lysis syndrome?

The risk is particularly high when patients have very high serum phosphorus levels and require intravenous calcium to treat symptomatic hypocalcemia. High solute concentration, low solubility, and slow urine flow make crystallization more likely and therefore increase the risk for tumor lysis syndrome.

What is the pathophysiology of Tumour lysis syndrome?

The pathophysiology involves massive tumor cell lysis resulting in the release of large amounts of potassium, phosphate, and uric acid. Deposition of uric acid and calcium phosphate crystals in the renal tubules may lead to acute renal failure, which is often exacerbated by concomitant intravascular volume depletion.

Why does TLS cause hypocalcemia?

Hypocalcemia in TLS has been attributed to intracellular phosphate forming complexes with free calcium after it is released into the blood stream [3]. Hypocalcemia can cause muscle cramps, tetany and seizures. It may also cause QT prolongation and impairment of cardiac contractility.

How does allopurinol prevent tumor lysis syndrome?

Medications can be adjusted after the start of chemotherapy in response to the level of tumor lysis and/or metabolic disturbances. Allopurinol, a xanthine oxidase inhibitor, reduces the conversion of nucleic acid byproducts to uric acid, in this way preventing urate nephropathy and subsequent oliguric renal failure.

Which type of kidney damage is related to the adverse effects of chemotherapy?

Multiple chemotherapy regimens have been associated with interstitial nephritis, most notably ipilimumab. In ipilimumab-induced interstitial nephritis, patients are treated with prednisone and quickly return to their baseline kidney function [7].

How can I protect my kidneys during chemo?

During treatment Certain medicines, such as amifostine (Ethyol), may be given to protect the kidneys from damage when nephrotoxic chemotherapy is given. The dose of the drug may be lowered or the drug may be stopped completely if there is kidney damage.

Is chemo hard on kidneys?

What causes kidney damage. Some chemotherapy drugs and biological therapies can cause kidney damage. [1] Chemotherapy causes renal dysfunction by damaging the blood vessels or structures of the kidneys.