Background: Survival rates of patients with APL have increased >90% with the introduction of all- transretinoic acid (ATRA) and arsenic trioxide (ATO). However in addition to infections that are common during leukemia induction, bleeding and differentiation syndrome (DS) are frequently seen and are potentially fatal complications unique to APL. Renal failure is considered to be a manifestation of DS but can also occur secondary to infections. Herein, we report development of renal insufficiency (RI) during induction and outcomes in a cohort of patients managed by our program.