Muramidasuria and Hyperkaluria in the Chloroleukemic Rat

A Forgotten Cause of Kidney Injury in Chronic Myelomonocytic Leukemia

“…The high level of tubular lysozyme may induce significant kaliuresis with severe hypokalemia. 15,16 Alternatively, lysozyme may induce direct tubular injury and kidney failure 7,8. It is worth mentioning that kidney injury from other cationic macromolecules has been reported in the literature.…”

Lysozyme: a brief review

“…Klockars et al (1974) observed proximal renal tubular lesions in chloroleukaemic rats with elevated lysozyme levels, but these workers were unable to reproduce such lesions in normal rats after the intra-aortic administration of lysozyme. Other workers (Rosenthal, Maglio and Moloney, 1972;Greenberger, Rosenthal and Moloney, 1973) have demonstrated in chloroleukaemic and normal rats that only prolonged elevation in serum lysozyme causes lysozymuria and hyperkaluria. Mason, Howes and Taylor (1975) found no tubular maximum (Tm) for resorption of lysozyme in the perfused rat kidney, and lysozymuria occurred even at low perfusate levels of lysozyme.…”

Lysozyme and hypokalaemia

“…Hypokalaemia in AML occurs in well over 50% of patients and is probably multifactorial (Mir et al, 1975;Mir and Delamore, 1978). Rosenthal, Maglio and Moloney (1972) showed that prolonged elevation of serum lysozyme in chloroleukaemic rats causes lysozymuria and hyperkaluria. Both tuberculosis and sarcoidosis are chronic diseases and serum lysozyme concentrations probably remain elevated longer in these diseases than they do in AML which is an acute disease with a rapid onset and, in most cases, runs an acute course.…”