UMEM Educational Pearls

Category: Critical Care

Title: Acute Kidney Injury and Tumor Lysis Syndrome

Posted: 6/26/2012 by Mike Winters, MD (Updated: 9/29/2023)
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Acute Kidney Injury and Tumor Lysis Syndrome

Tumor lysis syndrome (TLS) is characterized by hyperkalemia, hyperphosphatemia, hypocalcemia, and hyperuricemia.
Acute kidney injury in TLS increases patient mortality and can be caused by an obstructive uropathy from calcium phosphate crystalluria or uric acid crystal precipitation.
Fluid resuscitation remains the primary treatment for TLS.
Urine alkalinization, however, is no longer recommended, as it can result in calcium phosphate crystal precipitation.
Recombinant urate oxidase rapidly decreases uric acid levels and should be given to patients at high-risk for TLS and those with pre-existing kidney disease and high uric acid levels.

McCurdy MT, Shanholtz CB. Oncologic emergencies. Crit Care Med 2012; 40:2212-2222.