Benítez H, Arreguín L, Velásquez L, Bernaldez R, Juan L, Farfán J, Díaz S, Gaona A, Martínez M C
Departamento de Nefrología, Hospital Infantil de México Federico Gómez, México, D.F.
Sangre (Barc). 1995 Jun;40(3):213-7.
The alterations of the water-electrolyte balance are among the commonest early complications of treatment in children with acute lymphoblastic leukaemia (ALL). A study was carried out in thirteen patients with ALL aged between 1.5 and 14 years. Four had high risk ALL and nine had standard risk ALL. All patients received intravenous epirubicin and vincristine, per os prednisone, allopurinol and bicarbonate, and intrathecal methotrexate and hydrocortisone. Venous blood was drawn before starting therapy and on days second and sixth of treatment in order to assay sodium, potassium, calcium, phosphate, magnesium, albumin, urea nitrogen, creatinine and uric acid concentrations. The following alterations were found: hyponatraemia in 4 cases, hypokalemia in 9, hypomagnesaemia in 9, hypocalcaemia in 11, hypophosphataemia in 9, hypouricemia in 3 and hyperuricaemia in 3 others. None of the patients developed acute renal insufficiency. These abnormalities could be due to the leukaemia itself or appear as a consequence of the remission induction treatment.
水电解质平衡紊乱是急性淋巴细胞白血病（ALL）患儿治疗最常见的早期并发症之一。对13例年龄在1.5至14岁之间的ALL患儿进行了一项研究。其中4例为高危ALL，9例为标准风险ALL。所有患者均接受静脉注射表柔比星和长春新碱、口服泼尼松、别嘌醇和碳酸氢盐，以及鞘内注射甲氨蝶呤和氢化可的松。在开始治疗前以及治疗的第二天和第六天采集静脉血，以检测钠、钾、钙、磷、镁、白蛋白、尿素氮、肌酐和尿酸浓度。发现以下变化：4例低钠血症、9例低钾血症、9例低镁血症、11例低钙血症、9例低磷血症、3例低尿酸血症和另外3例高尿酸血症。没有患者发生急性肾功能不全。这些异常可能是由于白血病本身引起的，也可能是缓解诱导治疗的结果。
