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

Tumor lysis syndrome (TLS) is a life-threatening condition due to the rapid release of tumor cell contents into the blood- stream 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.