Hemodialysis for hyperkalemia due to tumor lysis syndrome in a child with T-cell acute 
lymphoblastic leukemia：Pediatric case report

Abstract

Background: Tumor lysis syndrome（TLS）is a life-threatening disorder characterized by multiple organ failure resulting from the rapid collapse of malignant tumors. Here, we present a pediatric case of T-cell acute lymphocytic leukemia（T-ALL）accompanied by hyperkalemia induced by TLS, requiring emergency hemodialysis. Case: A 15-year-old boy, weighing 52.9 kg was diagnosed with T-ALL and was identified as a high-risk for TLS. Following the initiation of prednisolone（15 mg/m²）, his serum potassium and creatinine levels increased to 7.3 mmol/L and 1.77 mg/dL, respectively. An electrocardiogram revealed T wave elevation, prompting the administration of emergency hemodialysis（HD）to address the hyperkalemia and acute renal failure due to TLS. We prescribed a blood flow rate of 160 mL/min and a dialysate flow rate of 500 mL/min, using heparin as an anticoagulant. After 4 hours, potassium and creatinine levels improved to 4.4 mmol/L and 0.81 mg/dL, respectively and the patient is currently undergoing maintenance therapy for T-ALL. Conclusion: The modality of renal replacement therapy（RRT）is necessary to consider for each case and to perform RRT promptly when necessary.