TLS prophylaxis aims to prevent which complication?

• A. Uric acid nephropathy
• B. Platelet transfusion
• C. Hypokalemia
• D. Hyponatremia

Answer: (A)

The major complication TLS prophylaxis aims to prevent is uric acid nephropathy. When tumor cells break down rapidly, purines are released and converted to uric acid. If uric acid builds up, it can crystallize in the renal tubules, leading to acute kidney injury. Preventing that uric acid buildup keeps the kidneys functioning. This is achieved with aggressive IV hydration to maintain urine flow and with drugs that lower uric acid levels: allopurinol to block new uric acid formation, or rasburicase to rapidly convert existing uric acid into a more soluble form. While TLS can cause electrolyte shifts, the protective focus is on minimizing uric acid–related kidney damage rather than on platelet counts or specific electrolyte disturbances like hypokalemia or hyponatremia.