Electrolytes abnormalities in cancer patients

Abstract

Electrolyte abnormalities are frequent in cancer patients, arising from the malignancy itself, anticancer therapies, or treatment-related complications. Hyponatremia, hypokalemia, hypomagnesemia, hypophosphatemia, and hypercalcemia occur through diverse mechanisms including endocrine dysfunction, renal tubular injury, gastrointestinal loss, cytokine-driven effects, and metabolic shifts during hematologic recovery. Novel agents such as immune checkpoint inhibitors, CAR-T therapy, targeted therapies, and transplant regimens have expanded both the spectrum and complexity of these disorders. These abnormalities can be clinically subtle yet contribute to morbidity, treatment delays, and poorer outcomes. Management requires timely recognition, targeted laboratory evaluation, and etiology-specific interventions such as hormone replacement, cytokine blockade, electrolyte repletion, and antiresorptive therapy. This review synthesizes current knowledge on therapy-associated electrolyte disturbances in oncology, emphasizing underlying mechanisms, clinical impact, and practical strategies for diagnosis and management.