종양용해중후군에 의한 급성신부전증의 임상적 양상

Background: Tumor lysis syndrome (TLS) occurs as a result of the rapid release of intracellular ions and metabolites into the bloodstream which can overwhelm the reanl capacity to excrete and then increase to lifethreatening concentrations. The syndrome is characterized by hyperuricmia, hyperkalemia, hyperphos-phatemia and hypocalcemia. Recently, intensive chemotherapy for hematologic malignancy have introduced and tumor lysis syndorme occurred with increasing tendency. Methods: Renal and metabloic complications of tumor lysis of ten episodes are reviewed in nine patients with various hematologic malignancy during last 2 years. Results: The ten episodes of tumor lysis syndrome had developed in one of malignant lymphoma. five of acute lymphocytic leukemia and four of chronic myelocytic leukemia. The mean serum BUN and creatinine concentration was 68.0 and 4.4 mg/dl, respectively. The mean serum calcium was 5.2 mg/dl, phosphorus 11.5 mg/dl, uric acid 13.9mg/dl. Clinical manifestations of tumor lysis syndrome had developed abruptly within 24 hours after chemotherapy in all episodes. Prophylactic treatment including intravenous hydration, potent diuretics, alkalinization of urine and allopurinol were not always successful in preventing or aborting it. The two major clinical features of tumor lysis syndrome were oligoanuria (6/10) and neurologic symptoms such as carpopedal spasm (5/10). Conclusion: We had experienced ten episodes of tumor lysis syndrome from 9 patients. Except three patients who expired due to unrelated causes, the overall recovery was good. The mean recovery day in three conservative-treated patients and four hemodialysis- Bsekground: Tumor lysis syndrome (TLS) occurs as a result of the rapid release of intracellular ions and metabolites into the bloodstream which can overwhelm the reaol capacity to excrete and then increase to lifethreatening concentrations. The syndrome is characterized by hyperuricmia, hyperkalemia, hyperphos- phatemia and hypocalcemia. Recently, intensive chemotherapy for hematologic malignancy have introduced and tumor lysis syndorme occurred with increasing tendency. Methods: Renal and metabloic complications of tumor lysis of ten episodes are reviewed in nine patients with various hematologic malignancy during last 2 years. Results: The ten episodes of tumor lysis syndrome had developed in one of malignant lymphoma. five of acute lymphocytic leukemia and four of chronic myelocytic leukemia. The mean serum BUN and creatinine concentration was 68.0 and 4.4 mg/dl, respectively. The mean serum calcium was 5.2 mg/dl, phosphorus 11.5 mg/dl, uric acid 13.9mg/dl. Clinical manifestations of tumor lysis syndrome had developed abruptly within 24 hours after chemotherapy in all episodes. Prophylactic treatment including intravenous hydration, potent diuretics, alkalinization of urine and allopurinol were not always successful in preventing or aborting it. The two major clinical features of tumor lysis syndrome were oligoanuria (6/10) and neurologic symptoms such as carpopedal spasm (5/10). Conclusion: We had experienced ten episodes of tumor lysis syndrome from 9 patients. Except three patients who expired due to unrelated causes, the overall recovery was good. The mean recovery day in three conservative-treated patients and four hemodialysistreated patients was 10 and 16 days, respectively.