CONSULT ROUNDS: Tumor Lysis Syndrome 1

Tumor lysis syndrome(TLS) is a frequent clinical syndrome nephrologists encounter.
The Cairo Bishop classification allows for the diagnosis of TLS
Those are

1. Uric acid >= 8.0
2. K >= 6.0
3. Phos >= 4.6
4. Calcium <7.0
5. AKI
6. Cardiac arrhythmia
7. Seizure or symptomatic hypocalcemia

Two of the four lab criteria have to be met within 24 hours period and 3 days before to 7 days after receiving chemotherapy and no other cause of AKI has to be found.  Interestingly, LDH is not a criteria to help diagnose TLS but is usually the most useful clinically.  If one looks at risk factors, LDH is included along with WBC count, tumor burden, renal function at baseline and baseline uric acid levels.