Timing of Renal Replacement Therapy Initiation in Tumor Lysis Syndrome

University Hospital, Bordeaux800 enrolled

Overview

The TENDERS study aims to evaluate the impact of the timing of renal replacement therapy (RRT) initiation on outcomes in patients with tumor lysis syndrome (TLS) and associated acute kidney injury (AKI). The study will compare early versus delayed RRT initiation, examining the effect on renal function at 30 days post-treatment.

Tumor lysis syndrome (TLS) is a common and life-threatening complication in patients with hematologic malignancies, characterized by severe metabolic imbalances due to rapid tumor cell destruction. This syndrome frequently leads to acute kidney injury (AKI), requiring renal replacement therapy (RRT) in about 50% of cases. Despite its clinical significance, there is a lack of consensus on the optimal timing of RRT initiation in TLS-related AKI. Studies in other forms of AKI suggest no difference in outcomes between early and delayed RRT initiation, but these results are not directly applicable to TLS patients. This study seeks to fill this gap by analyzing the timing and outcomes of RRT initiation in TLS patients. The retrospective study will collect data from multiple intensive care units (ICUs) across France. Procedure: The study will retrospectively analyze patient data from 2013 to 2023, comparing early vs. delayed RRT initiation. Follow-up: Data on renal function, RRT usage, and mortality will be collected 30 days and one year after ICU admission.

Study Type

OBSERVATIONAL

Enrollment

800

Conditions

Renal Replacement Therapy for Acute Kidney Injury in ICU

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Adults aged ≥18 years. * Hospitalized in the ICU between January 1, 2013, and December 31, 2023. * Diagnosed with a hematologic malignancy or solid tumor requiring chemotherapy. * Diagnosed with TLS based on the presence of two or more biochemical criteria (e.g., hyperkalemia, hyperphosphatemia, hyperuricemia, hypocalcemia) within 3 days before or 7 days after chemotherapy initiation. Exclusion Criteria: * Patient or family opposition to data collection for research purposes. * Incomplete medical records that preclude data extraction.

Locations (10)

CHU d'Angers

Angers, France

WITHDRAWN

Hôpital Pellegrin

Bordeaux, France

RECRUITING

Hôpital la cavale blanche

Brest, France

Outcomes

Primary Outcomes

Renal dysfunction at ICU discharge

The primary outcome is renal dysfunction at ICU discharge, defined as a ≥25% increase in serum creatinine from baseline, assessed at the time of ICU discharge.

Time frame: From baseline to up to 30 days .

Secondary Outcomes

Incidence of AKI

Incidence of AKI related to Tumor lysis syndrome (TLS), assessed at ICU admission.

Time frame: At baseline

Use of RRT for TLS-related AKI

Use of RRT for TLS-related AKI, assessed during ICU stay.

Time frame: From baseline to up to 30 days.

Renal recovery

90-day renal recovery, assessed at 90 days post-admission.

Time frame: At 90 days after baseline

Long-term renal function

Long-term renal function is assessed by creatinine at one year

Time frame: 12 months after baseline

Mortality at 30 days

Mortality rate at 30 days.

Time frame: 30 days after baseline

Mortality at 12 months

Mortality rate 12 months post ICU admission

Time frame: 12 months after baseline

Long-term renal function

Long-term renal function is assessed by glomerular filtration rate at one year

Time frame: 12 months after baseline

Central Contacts

Arthur ORIEUX

CONTACT

05 56 70 56 79 arthur.orieux@chu-bordeaux.fr

Data from ClinicalTrials.gov

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