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Hydration effect on kidney function and serum electrolyte in children with tumor lysis syndrome (TLS) and risk of TLS

  • Yulistiani EMAIL logo , Claudia Tiffany , I. Dewa Gede Ugrasena and Mariyatul Qibtiyah
Published/Copyright: June 25, 2021

Abstract

Objectives

Tumor lysis syndrome (TLS) is a life-threatening oncology emergency disorder, which may cause acute kidney injury (AKI), arrhythmias, seizures, and sudden death. Hydration is used to prevent TLS in medium-high risk patients, and treatment in TLS patients. According to the pediatric protocol in Dr. Soetomo District General and Teaching Hospital, close monitoring is required to prevent the progression of hematological malignancy towards TLS. The study aimed to analyze the hydration effect on potassium, calcium, and phosphate levels; serum creatinine (sCr); and blood urea nitrogen (BUN) level.

Methods

This was an observational and prospective study conducted at Dr. Soetomo District General and Teaching Hospital for four months on 15 pediatric hemato–oncology patients who got TLS and in risk of TLS. Laboratory parameters were observed in 11 days, pre and post hydration.

Results

Among the 15 patients who met the inclusion criteria, there were eight TLS patients and seven TLS risk patients. After hydration administration 67% of TLS patients achieved normal potassium level, 75% achieved normal phosphate level, 0% achieved normal calcium level, and 50% achieved normal sCr and BUN levels. Meanwhile, TLS risk patients reached normal level in all parameters. This difference in performance is caused by disease progression.

Conclusions

Hydration can maintain serum electrolytes and renal function in a normal range, preventing TLS in TLS risk patients. In TLS patients, hydration only tends slow the progression of the disease.


Corresponding author: Yulistiani, Department of Clinical Pharmacy, Airlangga University Hospital, Surabaya, Indonesia, Phone: +628123013880, E-mail:

Acknowledgments

The authors thanked the Director and Head of the pediatric inpatients of Dr. Soetomo District General and Teaching Hospital.

  1. Research funding: None declared.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Authors state no conflict of interest.

  4. Informed consent: Informed consent was obtained from all individuals included in this study.

  5. Ethical approval: The local Institutional Review Board deemed the study exempt from review.

References

1. Howard, S, Jones, D, Pui, C. The tumor lysis syndrome. N Engl J Med 2011;364:1844–54.https://doi.org/10.1056/nejmra0904569.Search in Google Scholar

2. Edeani, A, Shirali, A. Tumor lysis syndrome. In: Onco-nephrology curriculum [internet]. Connecticut: American Society of Nephrology; 2016:1–8 pp.Search in Google Scholar

3. Belay, Y, Yirdaw, K, Enawgaw, B. Tumor lysis syndrome in patients with hematological malignancies. J Oncol 2017;2017:9684909. https://doi.org/10.1155/2017/9684909.Search in Google Scholar

4. Williams, SM, Killeen, AA. Tumor lysis syndrome. Arch Pathol Lab Med 2019;143:386–93.https://doi.org/10.5858/arpa.2017-0278-rs.Search in Google Scholar

5. Mirrakhimov, AE. Tumor lysis syndrome: a clinical review. World J Crit Care Med 2015;4:130.https://doi.org/10.5492/wjccm.v4.i2.130.Search in Google Scholar

6. Ñamendys-Silva, SA, Arredondo-Armenta, JM, Plata-Menchaca, EP, Guevara-García, H, García-Guillén, FJ, Rivero-Sigarroa, E, et al.. Tumor lysis syndrome in the emergency department: challenges and solutions. Open Access Emerg Med 2015;7:39–44. https://doi.org/10.2147/oaem.s73684.Search in Google Scholar

7. Tazi, I, Nafl, H, Elhoudzi, J, Mahmal, L, Harif, M. Management of pediatric tumor lysis syndrome. Arab J Nephrol Transplant 2011;4:147–54. https://doi.org/10.4314/ajnt.v4i3.71027.Search in Google Scholar

8. Li, HCW, Chung, OKJ, Tam, CJ, Chiu, SY. Effective prevention and management of tumor lysis syndrome in children with cancer. J Pediatr Oncol Nurs 2015.10.1177/1043454214555551Search in Google Scholar PubMed

9. Micho, H, Mohammed, Y, Hailu, D, Genet, S. Evaluation and characterization of tumor lysis syndrome before and after chemotherapy among pediatric oncology patients in Tikur Anbessa specialized hospital, Addis Ababa, Ethiopia. BMC Hematol 2018;18:1–7. https://doi.org/10.1186/s12878-018-0117-0.Search in Google Scholar

10. Al Bagshi, M, Hassan, ES, Sadek, AO, Abbas, AA. Tumor lysis syndrome in children with acute leukemia: incidence and outcome. J Appl Hematol 2013;4:100. https://doi.org/10.4103/1658-5127.123304.Search in Google Scholar

11. Marsh, A, Agrawal, AK, Feusner, JH. Tumor lysis syndrome. In: Feusner, J Hastings, C Agrawal, A. editors. Supportive care in pediatric oncology. Pediatric oncology. Berlin, Heidelberg: Springer;2015.10.1007/978-3-662-44317-0_3Search in Google Scholar

12. Amieva-Wang, N. A practical guide to pediatric emergency medicine, 1st ed. Cambridge: Cambridge University Press; 2011:357 p.Search in Google Scholar

13. Burns, RA, Topoz, I, Reynolds, SL. Tumor lysis syndrome: risk factors, diagnosis, and management. Pediatr Emerg Care 2014.10.1097/PEC.0000000000000195Search in Google Scholar

14. Naeem, B, Moorani, KN, Anjum, M, Imam, U. Tumor lysis syndrome in pediatric acute lymphoblastic leukemia at tertiary care center. Pak J Med Sci 2019;35:899–904.10.12669/pjms.35.4.715Search in Google Scholar

15. Daver, N, Kantarjian, H, Marcucci, G, Pierce, S, Brandt, M, Dinardo, C, et al.. Clinical characteristics and outcomes in patients with acute promyelocytic leukemia and hyperleucocytosis. Br J Haematol 2014;168:646–53.https://doi.org/10.1111/bjh.13189.Search in Google Scholar

16. Gong, J, Wu, B, Guo, T, Zhou, S, He, B, Hyperleukocytosis, PX. A report of five cases and review of the literature. Oncol Lett 2014;8:1825–7. https://doi.org/10.3892/ol.2014.2326.Search in Google Scholar

17. Burghi, G, Berrutti, D, Manzanares, W. Tumor lysis syndrome in intensive therapy : diagnostic and therapeutic encare. (English Ed [Internet]. Med Intensiva 2011;35:170–8. https://doi.org/10.1016/s2173-5727(11)70022-4.Search in Google Scholar

18. Avner, E, Yoshikawa, N, Harmon, W, Niaudet, P, Emma, F, Goldstein, S. Pediatric nephrology, 7th ed. London: Springer; 2016.10.1007/978-3-662-43596-0Search in Google Scholar

19. Alakel, N, Middeke, J, Schetelig, J, Bornhäuser, M. Prevention and treatment of tumor lysis syndrome , and the efficacy and role of Rasburicase. Onco Targets Ther 2017;10:597–605. https://doi.org/10.2147/ott.s103864.Search in Google Scholar

20. Kliegman, R, Stanton, B, St. Geme, J, Schor, N, Behrman, R, Nelson, W. Nelson textbook of pediatrics, 21st ed. Philadelphia: Elsevier; 2020.Search in Google Scholar

21. Wilson, FP, Berns, JS. Tumor lysis syndrome: new challenges and recent advances. Adv Chronic Kidney Dis [Internet] 2014;21:18–26. https://doi.org/10.1053/j.ackd.2013.07.001.Search in Google Scholar

22. Calvo Villas, JM. Tumour lysis syndrome. Med Clin (Barc) [Internet] 2019;152:397–404. https://doi.org/10.1016/j.medcle.2019.03.006.Search in Google Scholar

23. Sarno, J. Prevention and management of tumor lysis syndrome in adults with malignancy. J Adv Pract Oncol 2013;4:101–6.10.6004/jadpro.2013.4.2.4Search in Google Scholar

24. Adeyinka, A, Bashir, K. Tumor lysis syndrome [Internet]. Treasure Island: StatPearls Publishing; 2019. Available from: https://www.ncbi.nlm.nih.gov/books/NBK518985/.Search in Google Scholar

25. Howard, S. Tumor lysis syndrome. In: Abeloff’s clinical oncology, 6th ed. Philadelphia: Elsevier; 2020:572–80 pp.10.1016/B978-0-323-47674-4.00036-0Search in Google Scholar

26. Cairo, MS, Coiffier, B, Reiter, A, Younes, A. Recommendations for the evaluation of risk and prophylaxis of tumour lysis syndrome (TLS) in adults and children with malignant diseases: an expert TLS panel consensus. Br J Haematol 2010;149:578–86. https://doi.org/10.1111/j.1365-2141.2010.08143.x.Search in Google Scholar

27. Jones, G, Will, A, Jackson, G, Webb, N, Rule, S. Guidelines for the management of tumor lysis syndrome in adults and children with hematological malignancies on behalf of the British committee for standards in hematology. Br J Haematol 2015;169:661–71. https://doi.org/10.1111/bjh.13403.Search in Google Scholar

28. Held-warmkessel, J. Preventing and managing tumor lysis syndrome. Nurse 2010;40:26–31.https://doi.org/10.1097/01.nurse.0000367861.28564.32.Search in Google Scholar

Received: 2020-11-27
Accepted: 2021-02-23
Published Online: 2021-06-25

© 2021 Walter de Gruyter GmbH, Berlin/Boston

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