Impact of daytime continuous veno-venous haemofiltration on treatment of paediatric tumour lysis syndrome

J Int Med Res. 2018 Sep;46(9):3613-3620. doi: 10.1177/0300060518776426. Epub 2018 Jun 8.

Abstract

Objective Continuous renal replacement therapy (CRRT) is well suited for treating metabolic abnormalities and renal insufficiency associated with tumour lysis syndrome (TLS). However, there is controversy regarding the choice of time for CRRT, the selection of CRRT models, and methods of decreasing complications of CRRT. This study aimed to evaluate the efficacy and outcomes of daytime continuous veno-venous haemofiltration (CVVH) for treating paediatric TLS. Methods The clinical features, technique-related complications, and prognosis were prospectively analysed in eight paediatric patients with TLS who were supported by daytime CVVH in West China Second University Hospital, Sichuan University from January 2007 to July 2016. Results Seven patients were boys and one was a girl. All of the patients had hyperphosphataemia, and there were four cases of hyperkalaemia, four cases of hyperuricaemia, and two cases of hypocalcaemia. All of the patients received one to 10 CVVH treatments. Urine output, renal function, serum uric acid levels, and potassium, phosphate, and calcium levels returned to normal in all of the patients, but recovery of renal function was relatively slow. No significant adverse reactions were observed. All of the patients recovered and were discharged. Conclusion Daytime CVVH is a safe and effective treatment for paediatric TLS.

Keywords: Tumour lysis syndrome; acute kidney injury; children; continuous renal replacement therapy; continuous veno-venous haemofiltration; daytime; hyperphosphataemia.

Publication types

  • Clinical Study

MeSH terms

  • Acute Kidney Injury
  • Adolescent
  • Child
  • Female
  • Hemofiltration / instrumentation
  • Hemofiltration / methods*
  • Humans
  • Male
  • Prognosis
  • Time Factors
  • Tumor Lysis Syndrome / diagnosis
  • Tumor Lysis Syndrome / etiology
  • Tumor Lysis Syndrome / therapy*