Impact of early versus conventional kidney replacement therapy initiation in tumor lysis syndrome: a target trial emulation
Authors' conclusion
Our results do not support the strategy of KRT initiation based on a sole critical phosphatemia level in TLS patients.
Study context
- Population
- Consecutive ICU patients with laboratory tumor lysis syndrome (TLS), Saint-Louis University hospital (Paris) and Angers University hospital, January 2007–June 2020of 220 initial patients
- Participants
- 192 patients
- Exposure
- Phosphatemia threshold vs Conventional approach
- Outcome
- MAKE30 composite outcome (dialysis criterion:
- KRT requirement between day 7
- Day 30 only)
- Follow-up
- Day 30
Methodological detailsretrospective cohort study, cloning, censoring and weighting method, two-centre
- Retrospective cohort study
- Cloning, censoring and weighting method
- Two-centre
Main finding
As reported in the abstract
MAKE30
Patients meeting MAKE30 criteria
75
Observational data: associations, not effects.
Further findings
Factors associated with MAKE30 (multivariable analysis)
| OR (CI) | P value | ||
|---|---|---|---|
| KRT requirement during the first 7 daysMultivariable analysis | 4.01 (1.65–4.86) | P = 0.003 | |
| 0.20.5125Odds ratio (log scale) |
| Outcome | OR (CI) | P value | |
|---|---|---|---|
| Factors associated with MAKE30 (multivariable analysis)Non-renal SOFA · per 1 point increment · multivariable analysis | 1.39 (1.25–1.57) | P < 0.001 | |
| 0.512Odds ratio (log scale) |
TLS-related AKI
- Patients with TLS-related AKI
- 140
Original publication
Impact of early versus conventional kidney replacement therapy initiation in tumor lysis syndrome: a target trial emulation. Ann Intensive Care. Published 4 April 2025. doi:10.
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