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Published on: October 19, 2014
[Electrolyte abnormality and renal insufficiency in malignant lymphoma; clinical and pathological analysis in 123
1Akita University School of Medicine, Third Department of Internal Medicine.
Insights
Electrolyte abnormalities (EA) are common in malignant lymphoma (ML) patients, indicating disease progression before treatment. Post-treatment EA suggests disease advancement and therapy-related kidney damage.
Area of Science:
- Oncology
- Nephrology
- Internal Medicine
Context:
- Electrolyte abnormalities (EA) in malignant lymphoma (ML) patients are infrequently reported.
- This study investigates EA and renal insufficiency in 123 ML patients over 13 years.
Purpose:
- To analyze the incidence and causes of EA and renal insufficiency in ML patients before and after treatment.
- To determine the clinical significance of EA in ML progression and treatment outcomes.
Summary:
- Pre-treatment EA occurred in 24.2% of patients, predominantly hypercalcemia, hypocalcemia, and hyperkalemia.
- Post-treatment EA increased to 74.7%, with increased hyponatremia and hypokalemia. Renal insufficiency and proteinuria also rose significantly post-treatment.
- Pre-treatment EA correlated with higher LDH, advanced clinical stages, and bone marrow involvement, suggesting extrarenal causes.
- Post-treatment EA was linked to renal factors and therapy-related kidney damage, alongside disease progression.
Impact:
- EA before treatment serves as an indicator of malignant lymphoma progression.
- EA after treatment highlights both disease advancement and potential therapy-induced renal damage.
- Findings emphasize the importance of monitoring electrolyte and renal function in ML patients throughout treatment.
Abstract:
The clinical studies about the electrolyte abnormality (EA) in patients with malignant lymphoma (ML) are rarely reported. We analyzed the EA and renal insufficiency in 123 patients with ML between June. 1976 and Jan. 1989; 8 patients with Hodgkin's disease, and 115 patients with non-Hodgkin's lymphoma (NHL). Before treatment, the incidence of the EA was 24.2% and hypercalcemia, hypocalcemia, and hyperkalemia were predominant. After treatment it became to 74.7% and the number of hyponatremia and hypokalemia increased. The incidence of proteinuria and renal insufficiency (serum creatinine above 1.5 mg/dl), were 7.3% and 2.4% before treatment, and became to 26.8% and 26.8% after treatment, respectively. There was a significant difference between two groups with and without the EA before treatment as for serum lactate dehydrogenase (LDH) levels (p less than 0.01), clinical stages (p less than 0.05) and the incidence of bone marrow involvement (p less than 0.01). In 34 autopsied cases, 3 cases showed massive renal involvement and about a half of cases showed various renal changes. The EA before treatment was caused by extrarenal factors, because the incidence of proteinuria and renal insufficiency were almost same to healthy controls. And renal factors play an important role on the E.A after treatment. Above results suggest that the EA before treatment indicates the progress of malignant lymphoma and the EA after treatment means not only the progress of the disease but also therapy-related renal damages.
