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BRIEF REPORT
Year : 2020  |  Volume : 3  |  Issue : 2  |  Page : 67-70

Safety and efficacy of renal replacement therapy for acute kidney injury in tumor lysis syndrome


1 Department of Pediatric Intensive Care Unit, The Indus Hospital, Karachi, Pakistan
2 Pediatric Nephrology, The Indus Hospital, Karachi, Pakistan
3 Pediatric Oncology, The Indus Hospital, Karachi, Pakistan
4 Department of Research Evaluation Unit, College of Physician and Surgeons, Karachi, Pakistan

Correspondence Address:
Abdul Rahim Ahmed
Department of Pediatric ICU, The Indus Hospital, Karachi
Pakistan
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2589-9309.305900

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Tumor lysis syndrome (TLS) defines a constellation of metabolic abnormalities resulting from tumor cell death leading to dreaded clinical complications, including acute kidney injury (AKI). The incidence of AKI in TLS varies from 14% to 76% and is associated with mortality in 36% cases, and up to 20% of patients require renal replacement therapy (RRT). This study was done to evaluate the therapeutic efficacy and safety of RRT in children with hematological malignancies who develop AKI with TLS. We retrospectively reviewed case records of patients, up to 5 years old,with AKI due to TLS who required RRT during November 2017–October 2019 admitted in the pediatric intensive care unit (PICU). The diagnosis of TLS was based on Bishop–Cairo criteria. The primary outcome was recorded as recovery of renal function. Out of total 400 patients with newly diagnosed hematological malignancy admitted in the PICU during the study period, 122 (30.5%) developed TLS with 32 (26.2%) having AKI, of which eight patients (2%) underwent dialysis. The mean estimated glomerular filtration rate on admission was 36.6 ± 9.8 mg/ml/1.73 m2 with a mean urine output being 0.32 ± 0.1 ml/kg/h. Seven of eight patients underwent hemodialysis. All cases had successful RRT with normalization of renal function and establishment of adequate urine output. RRT is safe and effective in children for AKI with TLS with the recovery of renal functions.


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