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Berardi et al. J Cancer Metastasis Treat 2019;5:79 Journal of Cancer
DOI: 10.20517/2394-4722.2019.008 Metastasis and Treatment

Review Open Access

Electrolyte disorders in cancer patients: a
systematic review

Rossana Berardi, Mariangela Torniai, Edoardo Lenci, Federica Pecci, Francesca Morgese, Silvia Rinaldi

Clinica Oncologica, Università Politecnica delle Marche, Azienda Ospedaliero-Universitaria Ospedali Riuniti Umberto I - GM
Lancisi - G Salesi, Ancona 60126, Italy.
Correspondence to: Prof. Rossana Berardi, Clinica Oncologica, Università Politecnica delle Marche, Azienda Ospedaliero-
Universitaria Ospedali Riuniti di Ancona, Via Conca 71, Ancona 60126, Italy. E-mail: r.berardi@univpm.it

How to cite this article: Berardi R, Torniai M, Lenci E, Pecci F, Morgese F, Rinaldi S. Electrolyte disorders in cancer patients: a
systematic review. J Cancer Metastasis Treat 2019;5:79. http://dx.doi.org/10.20517/2394-4722.2019.008

Received: 26 Apr 2019 First Decision: 26 Jul 2019 Revised: 20 Nov 2019 Accepted: 20 Nov 2019 Published: 9 Dec 2019

Science Editor: Stephen J. Ralph Copy Editor: Jing-Wen Zhang Production Editor: Jing Yu

Abstract

Electrolyte disorders are very common complications in cancer patients. They might be associated to a worsening
outcome, influencing quality of life, possibility to receive anticancer drugs, and conditioning survival. In fact,
they might provoke important morbidity, with dysfunction of multiple organs and rarely causing life-threatening
conditions. Moreover, recent studies showed that they might worsen cancer patients’ outcome, while a prompt
correction seems to have a positive impact. Furthermore, there is evidence of a correlation between electrolyte
alterations and poorer performance status, delays in therapy commencement and continuation, and negative
treatment outcomes. These alterations usually involve sodium, potassium, calcium, and magnesium serum levels.
Several causes might contribute to electrolyte disorders in cancer patients: cancer effects, such as paraneoplastic
syndrome of inappropriate antidiuresis and tumor lysis syndrome; anti-cancer therapies; and other concomitant
clinical conditions or treatments. However, the origin of the electrolyte disorder is often multifactorial, thus
identifying and correcting the causes is not always feasible. Furthermore, they are often not recognized or not
considered in clinical practice, worsening these alterations and patient condition. An improvement of knowledge
about the physiological mechanisms underlying electrolyte disorders is necessary to strengthen their identification
and set up a prompt, adequate, and effective treatment. The aim of this systematic review is to provide an analysis of
the pathophysiological mechanisms of electrolyte abnormalities in cancer patients to facilitate their identification,
management, and therapy to improve patient outcome.

Keywords: Cancer, electrolyte disorders, hyponatremia, syndrome of inappropriate antidiuresis, hyperkalemia,
hypocalcemia, hypomagnesemia

© The Author(s) 2019. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

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