Kanno Y, Sakuyama M, Niitsu H, Ito T, Lee M, Ohtani H, Nakamoto Y, Miura A, Akihama T, Yamaguchi A
Third Department of Internal Medicine, Akita University School of Medicine.
Rinsho Ketsueki. 1992 Sep;33(9):1128-35.
Renal and electrolyte disturbances in 91 patients with chronic myelogenous leukemia (CML) were analyzed over a period of these twenty years. At diagnosis, renal and electrolytes were studied in 72 patients including 65 in chronic cases, 5 in accelerated phase and 2 in blastic crisis. There were 8 cases of hypocalcemia among 62 patients and 5 cases of hyperphosphatemia among 48 patients. The cases of hyperphosphatemia and renal dysfunction had short median survival. There were no significant differences of renal and electrolyte disturbances between before and after chemotherapy. Various electrolyte disturbances, that is, hyponatremia, hypo-, hyperkalemia, hypocalcemia, hypo-, hyperphosphatemia, were found in the blastic crisis of CML. In the last admission, renal dysfunction and various electrolyte disturbances were present in almost half of the cases. Pathological studies were performed in 18 autopsy cases. Acute tubular insufficiency or necrosis, hypercalcemic nephropathy, and renal infiltration of leukemic cells were recognized in patients who had renal dysfunction.
在20年的时间里，对91例慢性粒细胞白血病（CML）患者的肾脏和电解质紊乱情况进行了分析。诊断时，对72例患者进行了肾脏和电解质研究，其中慢性期65例，加速期5例，急变期2例。62例患者中有8例低钙血症，48例患者中有5例高磷血症。高磷血症和肾功能不全的患者中位生存期较短。化疗前后肾脏和电解质紊乱无显著差异。在CML急变期发现了各种电解质紊乱，即低钠血症、低钾血症、高钾血症、低钙血症、低磷血症、高磷血症。在最后一次入院时，几乎一半的病例存在肾功能不全和各种电解质紊乱。对18例尸检病例进行了病理研究。在有肾功能不全的患者中发现了急性肾小管功能不全或坏死、高钙血症肾病以及白血病细胞的肾脏浸润。
