Tislelizumab-induced distal renal tubular acidosis presenting with life-threatening hypokalemia: a case report - Takeaways - MDSpire

Tislelizumab-induced distal renal tubular acidosis presenting with life-threatening hypokalemia: a case report

  • By

  • Jiaju Xu

  • Lidong Qin

  • Ping Wang

  • Zhen Liu

  • Lili Yang

  • Hongwei Zhang

  • Yanqiu Wang

  • Jiao Gao

  • Meishu Zhao

  • Kaili Zhang

  • June 11, 2026

  • 0 min

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  • 1

    A 63-year-old man developed life-threatening hypokalemia and metabolic acidosis after receiving tislelizumab for lung cancer.

  • 2

    Laboratory tests revealed a serum potassium nadir of 1.1 mmol/L and urine pH of 7.0, indicating distal renal tubular acidosis.

  • 3

    Despite aggressive potassium supplementation, the patient's hypokalemia worsened, necessitating ICU admission and mechanical ventilation.

  • 4

    Tislelizumab was discontinued, and treatment with oral potassium citrate and prednisone led to complete resolution of metabolic abnormalities.

  • 5

    The case highlights the rarity of tislelizumab-induced distal renal tubular acidosis and the importance of early diagnosis and intervention.

Original Source(s)

Tislelizumab-induced distal renal tubular acidosis presenting with life-threatening hypokalemia: a case report

  • by Jiaju Xu, Lidong Qin, Ping Wang, Zhen Liu, Lili Yang, Hongwei Zhang, Yanqiu Wang, Jiao Gao, Meishu Zhao, Kaili Zhang

  • June 11, 2026

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