A 28-year-old woman was found to have stage IV Burkitt s lymphoma. Her renal function was normal and a staging CT scan had shown no abnormality of the renal tract. Three days later, when she was about to start chemotherapy, she developed a temperature of 39.0 C with rigors and was treated with imipenem. Investigations (the following day):serum sodium 138 mmol/L (137 144)serum potassium 6.2 mmol/L (3.5 4.9)serum creatinine 215 mol/L (60 110)serum corrected calcium 1.60 mmol/L (2.20 2.60)serum phosphate 1.52 mmol/L (0.8 1.4)serum lactate dehydrogenase 1238 U/L (10 250)serum urate 0.69 mmol/L (0.19 0.36)What is the most likely cause of the renal impairment?

A 28-year-old woman was found to have stage IV Burkitt s lymphoma. Her

1.	A 28-year-old woman was found to have stage IV Burkitt s lymphoma. Her renal function was normal and a staging CT scan had shown no abnormality of the renal tract. Three days later, when she was about to start chemotherapy, she developed a temperature of 39.0 C with rigors and was treated with imipenem. Investigations (the following day):serum sodium 138 mmol/L (137 144)serum potassium 6.2 mmol/L (3.5 4.9)serum creatinine 215 mol/L (60 110)serum corrected calcium 1.60 mmol/L (2.20 2.60)serum phosphate 1.52 mmol/L (0.8 1.4)serum lactate dehydrogenase 1238 U/L (10 250)serum urate 0.69 mmol/L (0.19 0.36)What is the most likely cause of the renal impairment?
A.	imipenem toxicity
B.	intravenous contrast toxicity
C.	kidney infiltration
D.	septic shock
E.	tumor lysis syndrome
Answer» F.

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