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肿瘤溶解综合征中急性肾损伤的管理:一项叙述性综述。

Management of acute kidney injury in tumor lysis syndrome: a narrative review.

作者信息

Zeppilli Laura, Morabito Santo, Gigante Antonietta, Pistolesi Valentina

机构信息

Hemodialysis Unit, Department of Internal Medicine and Clinical Sciences, Azienda Ospedaliero-Universitaria Policlinico Umberto I, Sapienza University of Rome, Viale del Policlinico, 155, 00161, Rome, Italy.

Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy.

出版信息

Intern Emerg Med. 2025 Jul 19. doi: 10.1007/s11739-025-04050-x.

Abstract

Tumor lysis syndrome (TLS) is a life-threatening condition due to the rapid release of tumor cell contents into the bloodstream usually induced by cytotoxic therapy. It is characterized by the rapid onset of severe metabolic derangements such as hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia. If not promptly recognized and treated, TLS can lead to serious clinical complications including acute kidney injury (AKI), cardiac arrhythmias, seizures, hypotension, and death. In particular, the occurrence of AKI could cause a delay in the administration of chemotherapy, thus compromising the efficacy of the treatment and contributing to worsening patient's prognosis. In this condition, a multidisciplinary approach appears crucial to implement strategies aimed at timely managing TLS and preventing AKI to improve main patient outcomes.

摘要

肿瘤溶解综合征(TLS)是一种危及生命的疾病,通常由细胞毒性疗法诱导肿瘤细胞内容物迅速释放到血液中所致。其特征是迅速出现严重的代谢紊乱,如高尿酸血症、高钾血症、高磷血症和低钙血症。如果不能及时识别和治疗,TLS可导致严重的临床并发症,包括急性肾损伤(AKI)、心律失常、癫痫发作、低血压和死亡。特别是,AKI的发生可能导致化疗延迟给药,从而影响治疗效果并导致患者预后恶化。在这种情况下,多学科方法对于实施旨在及时管理TLS和预防AKI以改善患者主要结局的策略似乎至关重要。

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