Electrolyte Dysregulation in Cancer Chemotherapy: Mechanisms, Clinical Significance and Future Perspectives

Electrolyte imbalances constitute a subtle yet clinically significant complication incancer chemotherapy and are often overlooked despite their profound impact on patient outcomes. These disturbances affect key electrolytes including sodium, potassium, magnesium, calcium and phosphate, arising from intricate interactions between cytotoxic agents and the body’s physiological regulatory mechanisms. Despite their prevalence, electrolyte abnormalities often remain underdiagnosed due to their nonspecific clinical manifestations, overlapping comorbid conditions and limited emphasis on systematic monitoring. Early recognition through consistent biochemical assessment and clinical vigilance is imperative to avert severe consequences such as cardiac arrhythmias, neuromuscular dysfunction and therapy discontinuation. Various chemotherapy agents, including platinum-based drugs and targeted therapies, can cause electrolyte imbalances through multiple pathways such as renal toxicity, inappropriate secretion of antidiuretic hormone (SIADH) and metabolic disturbances related to tumour lysis syndrome. Effective management requires timely correction and individualised supportive care. This review critically examines the underlying pathophysiological mechanisms, clinical significance, diagnostic complexities and therapeutic interventions associated with chemotherapy-induced electrolyte disturbances, emphasising the importance of implementing standardised monitoring frameworks to enhance safety, continuity of care and overall survival in oncology practice.