MANAGEMENT OF TUMOR LYSIS SYNDROME WITH STANDARD CONTINUOUS ARTERIOVENOUS HEMODIALYSIS - CASE-REPORT AND A REVIEW OF THE LITERATURE

Tumor lysis syndrome (TLS) is a critical illness with few treatment op tions. This report describes the clinical course of a patient with non -Hodgkin's lymphoma, who developed TLS and required renal replacement therapy. Institution of the standard therapeutic approach, intermitten t hemodialysis, was not possible because of persistent hypotension. In stead, the patient was treated with a short course of continuous arter iovenous hemofiltration (CAVH) and conventional continuous arterioveno us hemodialysis (CAVHD) with dialysate flow rate of 1 L/h), which resu lted in effective control of serum uric acid, potassium, urea nitrogen , phosphorus, and extracellular fluid volume. This case is in distinct ion to a previous report of TLS treatment with CAVHD using 4 L/h dialy sate flow rate. We conclude that continuous renal replacement therapie s with standard dialysate flow rates and replacement volumes should be considered for the treatment of TLS, particulary if the syndrome is a ccompanied by hypotension.