Electrolyte disorders secondary to venetoclax

Emerging cancer drugs introduce new forms of nephrotoxicity that may also present as electrolyte disorders. Here, we report a patient with non-Hodgkin lymphoma who developed severe hypokalaemia with concurrent hypophosphataemia, hypocalcaemia and hypomagnesaemia secondary to venetoclax. Although electrolyte disorders have been reported during treatment with venetoclax, these were ascribed to tumour lysis prophylaxis. Based on the temporal relationship and urinary studies, we show that venetoclax can cause these electrolyte disorders, likely through an effect on the proximal and distal convoluted tubule. In patients treated with venetoclax, we recommend close monitoring of electrolytes and avoiding co-medication that can contribute to electrolyte disorders.