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Chronic ifosfamide nephrotoxicity in children.

¹Sir James Spence Institute of Child Health, University of Newcastle upon Tyne, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne, United Kingdom. Roderick.Skinner@ncl.ac.uk

Medical and Pediatric Oncology

|July 18, 2003

Summary

Chronic ifosfamide treatment in children frequently causes kidney damage. Studies show significant nephrotoxicity persists 10 years later, with outcomes varying individually.

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Area of Science:

Pediatric Nephrology
Oncology
Pharmacology

Background:

Ifosfamide is a chemotherapy agent used in children.
Nephrotoxicity is a common and potentially serious complication of ifosfamide treatment.
Chronic renal damage can manifest as proximal tubular dysfunction (Fanconi syndrome) or glomerular impairment.

Purpose of the Study:

To evaluate the very long-term outcome of chronic ifosfamide-induced nephrotoxicity in children.
To assess changes in glomerular and tubular function 1 and 10 years after ifosfamide treatment completion.

Main Methods:

A cohort of 12 children treated with ifosfamide was studied.
Renal function, including glomerular and tubular parameters, was assessed 1 and 10 years post-treatment.

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Main Results:

No statistically significant change in overall glomerular or tubular toxicity was observed between 1 and 10 years.
Individual patient outcomes varied, with some showing improvement and others deterioration in renal function.
Significant nephrotoxicity remained present in the cohort a decade after treatment cessation.

Conclusions:

Chronic ifosfamide nephrotoxicity can persist for at least 10 years in pediatric patients.
Individual patient outcomes are variable, highlighting the need for personalized monitoring.
Risk factors include total dose, age, concurrent cisplatin, and unilateral nephrectomy, but prediction remains challenging.