A Combined Therapy for Hyperphosphatemia in the Tumor Lysis Syndrome: Hemodialysis and Continuo Arteriovenous Hemofiltration.
- Author:
Yoon Sook CHO
1
;
Jeong Sik BYUN
;
Ho Joon CHIN
;
Woo Seong HUH
;
Yeon Soo KIM
;
Dae Seog HEO
;
Cu Rie AHN
;
Jin Suk HAN
;
Suhng Gwon KIM
;
Jung Sang LEE
Author Information
1. Department of Internal Medicine, College of Medicine, Seoul National University, Seoul, Korea.
- Publication Type:Case Report
- Keywords:
Tumor lysis syndrome;
Hyperphosphatemia;
Hemodialysis CAVH (continuous arteriovenous hemofiltration)
- MeSH:
Adult;
Burkitt Lymphoma;
Death, Sudden, Cardiac;
Dialysis;
Drug Therapy;
Hemofiltration*;
Humans;
Hyperkalemia;
Hyperphosphatemia*;
Hyperuricemia;
Hypocalcemia;
Renal Dialysis*;
Renal Replacement Therapy;
Respiratory Insufficiency;
Tumor Lysis Syndrome*
- From:Korean Journal of Nephrology
1997;16(1):167-172
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
The acute tumor lysis syndrome is an acute illness caused by massive cell lysis after chemotherapies. This syndrome is characterized by hyperuricemia, hyperphosphatemia with hypocalcemia and hyperkalemia. Among these electrolyte abnormalities, the most serious complication is the severe hyperphosphatemia (greater than 14mg/dL) that could result in sudden cardiac arrest or respiratory failure. In order to correct the severe hyperphosphatemia, hemodialysis has been used commonly as the renal replacement therapy . However the hemodialysis can make posthemodialysis serum phosphate rebounded unless the patient take this treatment for more than 6 hours. Therefore it is not sufficient to use hemodialysis treatment alone. To solve this problem, hemodialysis has been used with or replaced by the uninterrupted dialysis technique such as CRRT (continuous renal replacement therapy). We report a 33-year-old man with Burkitt lymphoma who showed severe hyperphosphatemia (peak phosphate value was 18.6mg/dL) during the course of chemotherapy. used with 5 day CAVH (continuous arteriovenous hemofiltration) his phosphate level could be maintained without any rebound. Therefore we concluded that CAVH in conjunction with hemodialysis would be a successful way to control severe hyperphosphatemia associated with tumor lysis syndrome.
