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Progressive renal toxicity due to ifosfamide.

D Heney¹, J Wheeldon, P Rushworth

¹Department of Paediatrics and Child Health, St James's University Hospital, Leeds.

Archives of Disease in Childhood

|August 1, 1991

Summary

Ifosfamide treatment caused significant kidney damage in all children studied, affecting both tubular and glomerular functions. Long-term monitoring is crucial for detecting persistent renal toxicity in patients undergoing ifosfamide therapy.

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Area of Science:

Pediatric Oncology
Nephrology
Pharmacology

Background:

Ifosfamide is a widely used chemotherapy agent in pediatric oncology.
Renal toxicity is a known side effect of ifosfamide, but its long-term effects require further investigation.

Purpose of the Study:

To prospectively evaluate renal tubular and glomerular function in children receiving ifosfamide.
To assess the persistence of renal damage after ifosfamide treatment through follow-up examinations.

Main Methods:

Prospective study of 11 children treated with ifosfamide (continuous infusion).
Monitoring of urinary tubular markers (N-acetyl-glucosaminidase, alpha 1 microglobulin) and plasma phosphate.
Assessment of urinary albumin and use of electrophoresis to determine tubular or glomerular patterns.

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Follow-up study of seven patients to evaluate persistent renal damage.

Main Results:

All patients exhibited evidence of renal toxicity during ifosfamide treatment.
Significant increases in urinary tubular markers and decreases in plasma phosphate were observed.
Tubular damage persisted in all seven patients examined during follow-up.
Glomerular toxicity was less severe but also showed persistent damage in five of seven children.

Conclusions:

Ifosfamide treatment is associated with significant and often persistent renal toxicity in children.
Close monitoring of renal function during and after ifosfamide therapy is essential.
The study highlights the need for vigilant surveillance to manage potential long-term renal complications.