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Nephrotoxicity associated with ifosfamide

J Smeitink1, M Verreussel, C Schröder

  • 1Department of Paediatrics, University Hospital, Nijmegen, The Netherlands.

European Journal of Pediatrics
|November 1, 1988
PubMed

Insights

Ifosfamide treatment can cause irreversible Fanconi syndrome, a kidney disorder, in patients. Early intervention is crucial for managing this condition and its impact on glomerular function.

Area of Science:

  • Nephrology
  • Pediatric Oncology
  • Clinical Pharmacology

Background:

  • Ifosfamide is a widely used chemotherapeutic agent, particularly in pediatric oncology.
  • The SIOP-MMT 84 protocol outlines a specific dosing regimen for ifosfamide treatment.
  • Fanconi syndrome is a generalized proximal tubule disorder affecting renal reabsorption.

Observation:

  • Three patients treated with ifosfamide (3000 mg/m2 every 4 weeks for 10 months) developed Fanconi syndrome.
  • Impairment of glomerular function was noted, with endogenous creatinine clearance between 30-60 ml/min per 1.73 m2.
  • Renal lesions observed in these patients were irreversible.

Findings:

  • Chemotherapy with ifosfamide can induce Fanconi syndrome.
  • Ifosfamide-induced nephrotoxicity may lead to significant glomerular function impairment.
  • The renal damage associated with this syndrome can be permanent.

Implications:

  • Highlights the potential for severe, irreversible nephrotoxicity from ifosfamide therapy.
  • Stresses the critical need for early detection and substitution therapy in patients developing Fanconi syndrome.
  • Underscores the importance of monitoring renal function in patients undergoing prolonged ifosfamide treatment.

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