A 60-year-old man with newly diagnosed diffuse large B-cell lymphoma initiates chemotherapy. Within 48 hours, he develops acute kidney injury, hyperkalemia, hyperphosphatemia, and hypocalcemia. Which metabolic product is primarily responsible for the renal failure in this setting?
- A Lactic acid
- B Ammonia
- C Uric acid ✓
- D Pyruvic acid
Correct answer: C. Uric acid
Explanation
Tumor lysis syndrome results from rapid breakdown of tumor cells, releasing nucleic acids that are metabolized to uric acid. Uric acid precipitates in renal tubules causing obstructive nephropathy. Hyperkalemia, hyperphosphatemia, and hypocalcemia (due to calcium-phosphate precipitation) are the other classic features. Lactic acidosis is seen in sepsis or ischemia, not specifically in tumor lysis.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.