Lymphoma-Induced Renal Failure: Prevention, Symptoms, and Treatment

2023-11-01 23:01:40

The human kidneys have an important function and are responsible for excreting waste products and excess water produced by metabolism from the body. Other functions of the kidneys include activating vitamin D to maintain bone health; they are also responsible for producing “erythropoietin” (Erythropoietin), which stimulates the bone marrow to produce red blood cells. The kidneys also secrete “Renin”, which controls the secretion of hormones from the “Adrenal gland”: “Aldosterone”, which helps fine-tune blood pressure, blood volume and blood electrolyte concentration. If the kidneys are damaged and fail, the consequences will be serious; dehydration and obstruction of the urinary tract system can affect kidney function.

After cancer patients receive chemotherapy or targeted drug treatment, cancer cells undergo rapid apoptosis, which may lead to “Tumour lysis syndrome”, “Highly aggressive lymphoma” and “Acute lymphoblastic leukemia” (Acute lymphoblastic leukemia) is particularly high-risk; cancer cells grow quickly and die quickly following chemotherapy, which can easily induce “tumor lysis syndrome”. The risk of cancer increases greatly when the number of cancer cells is large, the growth rate is fast, and the response to chemotherapy is strong.

Human cells have high levels of “Potassium ions”, “Phosphate salts” and “Uric acid”, and the same goes for “cancer cells”. After cancer cells undergo apoptosis, large amounts of potassium ions, phosphates and and uric acid is released into the blood, which is a high-risk situation. Increased blood potassium (Hyperkalaemia) affects muscle function and can also cause “arrhythmia”, which can be fatal. Large amounts of uric acid and phosphoric acid form crystals that accumulate in the kidneys, which can lead to “acute renal failure” (Acute renal failure), reduced urine output (Oliguria), or even anuria (Auria). The patient may need “dialysis” to survive. Prevention is better than cure. Before high-risk patients receive chemotherapy, they must receive large doses of intravenous fluids to increase urine output, and take uric acid-lowering drugs and sodium bicarbonate at the same time. The former lowers uric acid, and the latter alkalizes urine, which can help relieve sleepiness.

Mr. Chen, a fifty-year-old man, has been experiencing abdominal discomfort recently and often feels a dull pain. His urine output has decreased, and edema has occurred all over his body. A positron emission tomography scan showed that the abdominal lymph nodes were swollen and formed a large mass; the tumor pressed on both sides of the urinary ducts, causing the kidneys to swell and seriously affecting kidney function. The biopsy confirmed the diagnosis of “diffuse large B cell lymphoma”, which is highly toxic. The doctor used a cystoscope (Cystoscpy) to insert a stent to open the two urinary tracts, and then administered anti-B cell monoclonal antibody therapy plus chemotherapy to quickly relieve the condition.

(This column is published every other Thursday)

Written by: Dr. Liang Xiansu, Hematologist and Hematology Oncologist

Column name: Medical Qing’s medical sentiment

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Lymphoma induces renal failure – Qingbao – Life Supplement – Column – D231102

Lymphoma induces renal failure – Qingbao – Life Supplement – Column

The human kidneys have an important function and are responsible for excreting waste products and excess water produced by metabolism from the body. Other functions of the kidneys include activating vitamin D to maintain bone health; they are also responsible for producing “erythropoietin” (Erythropoietin), which stimulates the bone marrow to produce red blood cells.kidney

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