Hyperuricemic Syndromes in Cancer Patients

Tsimberidou, Apostolia M.; Keating, Michael J.

doi:10.1159/000082541

Cited by 17 publications

(19 citation statements)

References 75 publications

(102 reference statements)

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“…The best known example of crystal-induced tubulopathy is tumor lysis syndrome in which the pathogenesis of AKI is thought to be mediated by the precipitation of uric acid into crystals that obstruct the distal tubules and collecting ducts of the kidney [20], [21], [22]. Typically this occurs when a subject with a large tumor burden is treated with chemotherapy, especially in subjects where the tumor is extremely sensitive to such therapy such as after cytoreductive therapy for leukemia or lymphoma [23].…”

Section: Uric Acid In Acute Kidney Injurymentioning

confidence: 99%

Serum uric acid and acute kidney injury: A mini review

Hahn¹,

Kanbay

Lanaspa

et al. 2017

Journal of Advanced Research

101

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Section: Uric Acid In Acute Kidney Injurymentioning

confidence: 99%

Serum uric acid and acute kidney injury: A mini review

Hahn¹,

Kanbay

Lanaspa

et al. 2017

Journal of Advanced Research

101

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“…XOR plays a prominent role in both cancer types as the source of UA, and current therapies are directed at inhibition of XOR with allopurinol or Febuxostat and degradation of the SUA using recombinant uricase (Rasburicase). Recent reviews provide excellent discussion of both cancer states and therapeutic strategies for reducing the associated hyperuricemia [141,142]. …”

Section: Reviewmentioning

confidence: 99%

Contribution of uric acid to cancer risk, recurrence, and mortality

Fini

Elias²,

Johnson

et al. 2012

Clinical & Translational Med

192

166

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Two risk factors for the development and progression of cancers that are amenable to life style modification are chronic inflammation and the metabolic syndrome. This review proposes two new targets that may mechanistically integrate inflammation and metabolic syndrome, have been largely ignored, and are known to be druggable. Recent evidence has demonstrated that elevated serum uric acid (hyperuricemia) is associated with excess cancer risk, recurrence, and mortality. Although uric acid (UA) can function as a systemic antioxidant, its pro‐inflammatory properties have been postulated to play an important role in the pathogenesis of cancer. Furthermore, obesity, Type 2 Diabetes Mellitus (T2DM), and the metabolic syndrome (MetS) are also associated with excess cancer, chronic inflammation, and with hyperuricemia, suggesting that UA may represent an important link between these disorders and the development of cancer. While pharmacological modulation of hyperuricemia could in principal augment anti‐cancer therapeutic strategies, some cancer cells express low intracellular levels of the enzyme Xanthine Oxidoreductase (XOR) that are associated with increased cancer aggressiveness and poor clinical outcome. Thus, systemic pharmacological inhibition of XOR may worsen clinical outcome, and specific strategies that target serum uric acid (SUA) without inhibiting tumor cell XOR may create new therapeutic opportunities for cancer associated with hyperuricemia. This review will summarize the evidence that elevated SUA may be a true risk factor for cancer incidence and mortality, and mechanisms by which UA may contribute to cancer pathogenesis will be discussed in the hope that these will identify new opportunities for cancer management.

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“…Univariate analysis revealed that hyperuricemia was associated with azotemia, hypercreatinemia, high LDH, and high white blood cell counts (the latter only in patients with leukemia), which is almost in accordance with previous reports. [2,4,7] We encountered two patients with clinical TLS in this investigation. Our definition for clinical TLS is having two or more metabolic disorders of hyperuricemia, hypercreatinemia, azotemia, and hyponatremia with oliguria.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4] Hyperuricemia usually occurs after the initiation of cancer chemotherapy, although it sometimes occurs spontaneously without any treatment. Tumor lysis syndrome (TLS) is a severe and deleterious form of several metabolic disorders, including hyperuricemia, hyperkalemia, hyperphosphatemia, and azotemia.…”

Section: Introductionmentioning

confidence: 99%

Hyperuricemia in Pediatric Malignancies Before Treatment

Nagai

Kubota

et al. 2011

Nucleosides, Nucleotides and Nucleic Acids

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The objective of this study was to clarify the prevalence and characteristics of hyperuricemia in various pediatric malignancies before the initiation of treatment. We conducted a retrospective analysis of 119 children with various newly diagnosed malignancies between April 2000 and March 2010. On the basis of the reference values previously established in our laboratory, hyperuricemia was defined as uric acid (UA) levels above 2 standard deviations (s.d.) over the mean values at each age. Thirty-six patients (30.3%) showed hyperuricemia. Hyperuricemia was more common in male patients (36.8%) than in female patients (21.6%). The prevalence of hyperuricemia was highest in patients with lymphoma followed by those with acute lymphoblastic leukemia (ALL). When the study population was divided into hyperuricemia-negative and -positive populations, blood urea nitrogen, creatinine, and lactate dehydrogenase levels, and white blood cell counts (only in leukemia) were found to be significantly higher in the latter group by a univariate analysis. This study highlights useful information for identifying patients with malignancies at risk for tumor lysis syndrome (TLS) before starting chemotherapy.

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Hyperuricemic Syndromes in Cancer Patients

Abstract: Early recognition of metabolic abnormalities in cancer patients at risk for hyperuricemia is essential for proper therapy. Prospective studies to assess the incidence of and risk factors for hyperuricemic syndromes in patients treated with uricolytic agents are needed.

Cited by 17 publications

References 75 publications

Serum uric acid and acute kidney injury: A mini review

Serum uric acid and acute kidney injury: A mini review

Contribution of uric acid to cancer risk, recurrence, and mortality

Hyperuricemia in Pediatric Malignancies Before Treatment

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