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      Lesión renal aguda secundaria a lisis tumoral inducida por esteroides en una adolescente con leucemia linfoblástica aguda: Rol de la alcalinización urinaria y diálisis peritoneal Translated title: Acute kidney injury secondary to steroid-induced tumor lysis in an adolescent with acute lymphoblastic leukemia: Role of urinary alkalinisation and peritoneal dialysis

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          Abstract

          Una adolescente con leucemia linfoblástica aguda desarrolló un síndrome de lisis tumoral precoz y grave con lesión renal aguda luego de una dosis única y baja de esteroides. La disfunción renal se atribuyó primariamente a una nefropatía por fosfato con nefrocalcinosis debido a elevaciones extremas de este componente en sangre. La alcalinización urinaria probablemente contribuyó a su patogenia. Se utilizó diálisis peritoneal con resolución de la nefrocalcinosis y normalización de la depuración de creatinina.

          Translated abstract

          An adolescent with acute lymphoblastic leukemia developed an early and severe tumor lysis syndrome with acute kidney injury after a low and single dose of steroids. Renal dysfunction was attributed primarily to phosphate nephropathy with nephrocalcinosis due to extreme elevations of phosphate in blood. Urinary alkalinization probably contributed to this development. We used peritoneal dialysis with resolution of nephrocalcinosis and normalization of creatinine clearance.

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          Most cited references 17

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          Phosphate Elimination in Modalities of Hemodialysis and Peritoneal Dialysis

          Hyperphosphatemia is highly prevalent in hemodialysis (HD) and peritoneal dialysis (PD) patients and is a major risk factor for cardiovascular mortality. Elimination of inorganic phosphate by dialysis is a cornerstone of the management of hyperphosphatemia. Phosphate clearance during HD is affected by various factors of dialysis prescription, such as blood and dialysate flow rate, dialyzer membrane surface area and ultrafiltration volume. Phosphate mass removal can be improved by hemodiafiltration, increased dialysis frequencies and extended treatment times. Short daily or extended daily or 3 times weekly nocturnal HD allow higher phosphate mass removal and potentially complete discontinuation of phosphate binder medication. In PD, phosphate mass removal appears to be correlated with peritoneal creatinine but not urea clearance. In hyperphosphatemic PD patients, the decision on the optimal PD modality should be based on peritoneal creatinine and ideally also on peritoneal phosphate transport characteristics.
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            Phosphate Elimination in Modalities of Hemodialysis and Peritoneal Dialysis

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              Hyperphosphatemia, hypocalcemia, and transient renal failure. Results of cytotoxic treatment of acute lymphoblastic leukemia.

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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Journal
                aap
                Archivos argentinos de pediatría
                Arch. argent. pediatr.
                Sociedad Argentina de Pediatría (Buenos Aires )
                1668-3501
                December 2012
                : 110
                : 6
                : e118-e122
                Affiliations
                [1 ] Hospital de Niños Héctor Quintana Argentina
                [2 ] Hospital de Niños Héctor Quintana Argentina
                Article
                S0325-00752012000600013
                Product
                Product Information: website
                Categories
                PEDIATRICS

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