July 23, 2026 · BMJ (Clinical research ed.) · DOI: 10.1136/bmj-2026-100040

Early treatment with rasburicase and risk of kidney replacement therapy and death in adults with tumour lysis syndrome: emulated target trial

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The authors aimed to investigate the impact of early rasburicase treatment on the risk of acute kidney injury requiring kidney replacement therapy or death in adults with tumor lysis syndrome (TLS). Their findings indicate that administering rasburicase within 12 hours of TLS onset is associated with a significantly lower risk of these adverse outcomes compared to delayed treatment or no treatment at all. Specifically, early treatment reduced the risk of acute kidney injury or death by approximately one third.

Tushar Shenoy, Daniel Sanchez-Almanzar, Julie-Alexia Dias, Robert Hayden, Michael Gs Shashaty, Abinet M Aklilu, Rushad Patell, Shuchi Anand, Amanda Renaghan, Claude Bassil, Javier A Neyra, Anip Bansal, Chintan V Shah, Shruti Gupta, Meghan E Sise, Rituvanthikaa Seethapathy, Sydney Chase, Cyrilee Thompson, Raghu Radhakrishnan, Eesha Verma, Jian Ni, Steven T Hoge, Victoria Lypka, Rafia Ali, Audrey E Monson, Sarah Kaunfer, Elizabeth Angus, Stephen Griffiths, Clara Walling, Nadia Al Haddad, Christina Hw Brotman, Todd Miano, Anushree C Shirali, David J Turco, Saieda A Alleyne, Kyra Shelton, Shahzad Shaefi, Daniela Garcia, Atif Nasim, Naveed Jan, Phuong H Nguyen, Susan Ziolkowski, Nivetha Subramanian, Vigneshwar Subramanian, Neha Debnath, Czarina T Faldu, Kavindya Wickramasinghe, Brian P Donahue, Anish Shah, Jessica Shostak, Vaishnavi Jayakumar, Jasmine Nadayil, Rachid Baz, Tomonori Takeuchi, Stefania Renzi, Aqeeb Ur Rehman, Natalia Nombera-Aznaran, Mariam Charkviani, Megan Kotzin, Jeff Kaiser, Madison Edwards, Akash Mathavan, Akshay Mathavan, Faith Obimdike, Nikita Shah, Ann S LaCasce, Philippe Armand, David E Leaf

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