[Electrolyte disorders in oncological patients]

Bull Cancer. 2024 Jul-Aug;111(7-8):687-700. doi: 10.1016/j.bulcan.2023.04.014. Epub 2023 May 17.
[Article in French]

Abstract

Electrolyte disorders (ED) are common in patients with cancer and in most cases, the etiologies do not differ from the general population. They may also be induced by the cancer, its therapy or paraneoplastic syndromes. ED are associated with poor outcomes, increased morbidity and mortality in this population. Hyponatremia is the most common disorder, often multifactorial, iatrogenic or secondary to the syndrome of inappropriate antidiuretic hormone secretion, usually due to small cell lung cancer. More rarely, hyponatremia may reveal adrenal insufficiency. Hypokalemia is generally multifactorial and associated with other ED. Cisplatin and ifosfamide induce proximal tubulopathies with hypokalemia and/or hypophosphatemia. Hypomagnesemia is often iatrogenic, related to cisplatin or cetuximab, but can be prevented by supplementation. Hypercalcemia can impair life quality and be life-threatening in the most severe cases. Hypocalcemia is less common and often of iatrogenic origin. Finally, the tumor lysis syndrome is a diagnostic and therapeutic emergency that affects the prognosis of patients. Its incidence tends to increase in solid oncology, related to the improvement of therapies. Prevention and early diagnosis of ED are essential to optimize the overall management of patients with underlying cancer and cancer therapy. The aim of this review is to synthesize most frequent ED and their management.

Keywords: Cancer; Electrolyte disorders; Hypercalcemia; Hypercalcémie; Hypomagnesemia; Hypomagnésémie; Hyponatremia; Hyponatrémie; Syndrome de lyse tumorale; Troubles hydro-électrolytiques; Tumor lysis syndrome.

Publication types

  • English Abstract
  • Review

MeSH terms

  • Antineoplastic Agents / adverse effects
  • Humans
  • Hypercalcemia* / etiology
  • Hypercalcemia* / therapy
  • Hypocalcemia* / chemically induced
  • Hypocalcemia* / etiology
  • Hypokalemia* / chemically induced
  • Hypokalemia* / etiology
  • Hyponatremia* / etiology
  • Hyponatremia* / therapy
  • Hypophosphatemia / chemically induced
  • Hypophosphatemia / etiology
  • Iatrogenic Disease
  • Inappropriate ADH Syndrome / complications
  • Magnesium Deficiency / chemically induced
  • Magnesium Deficiency / complications
  • Neoplasms* / complications
  • Neoplasms* / drug therapy
  • Paraneoplastic Syndromes / etiology
  • Tumor Lysis Syndrome* / etiology
  • Water-Electrolyte Imbalance* / chemically induced
  • Water-Electrolyte Imbalance* / etiology

Substances

  • Antineoplastic Agents