Uremia Complicating Leukemia Chemotherapy

Acute Uric Acid Nephropathy

“…2). At this time, 3 -The course in Case 4 following onset of anuria. The diuresis is less than expected in response to 280 gm.…”

“…Increased urinary urate excretion may exceed the ability of the renal tubules to keep urates in solution: Acute renal failure secondary to urate crystallization in the kidneys and genitourinary tract is a sequel. [1][2][3] In the past, if urine flow could not be maintained in the hyperuricemic patient by water loading and alkali therapy, procedures such as ureteral catheterization, nephrostomy, or hemodialysis were required to prevent death from acute renal failure.4 In two patients with severe hyperuricemia, azotemia, and oliguria unresponsive to water loading and alkali therapy, we have been able to avoid hemodialysis. The favorable result in their cases has prompted this report.…”

Emergencies in Hematology: Tumor Lysis Syndrome

“…Chemotherapy-induced TLS emerged shortly after effective medicines for leukemia and lymphoma were identified in the early part of the twentieth century. Several publications [1][2][3] described uric acid nephropathy and abrupt renal failure within days of treatment with these new drugs. Lysis of tumor cells, as later established, leads in the discharge of cell contents such as electrolytes, proteins, and nucleic acids into the circulation.…”