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Ifosfamide nephrotoxicity in adult patients

Gaël Ensergueix1, Nicolas Pallet1, Dominique Joly2

  • 1Department of Nephrology, Dialysis, Transplantation, Georges Pompidou European Hospital, Paris, France.

Clinical Kidney Journal
|September 8, 2020
PubMed
Abstract

Insights

Ifosfamide chemotherapy can cause significant kidney damage in adults, including acute kidney injury and chronic kidney disease. Age and cisplatin co-administration are identified risk factors for severe outcomes.

Area of Science:

  • Nephrology
  • Oncology
  • Toxicology

Background:

  • Ifosfamide is a common chemotherapy drug.
  • Nephrotoxicity is a known side effect of ifosfamide.
  • Limited data exist on ifosfamide nephrotoxicity in adults.

Purpose of the Study:

  • To characterize adult ifosfamide nephrotoxicity.
  • To describe clinical, biological, and histological features.
  • To identify risk factors and outcomes.

Main Methods:

  • Retrospective study of 34 adult patients.
  • Analysis of kidney function, renal biopsies, and outcomes.
  • Median follow-up of 31 months.

Main Results:

  • Ifosfamide nephrotoxicity presented as acute kidney injury, chronic kidney disease, or proximal tubular dysfunction.
  • Renal biopsies showed acute tubular necrosis, epithelial cell changes, inflammation, and fibrosis.
  • Mitochondrial toxicity was observed on electron microscopy.
  • Risk factors for Stage 5 CKD included older age and cisplatin co-administration.

Conclusions:

  • Ifosfamide causes significant kidney damage in adults.
  • Early identification and risk factor management are crucial.
  • Further research into protective strategies is warranted.
Keywords:
acute kidney injurychronic kidney injuryifosfamidemitochondrial toxicitynephrotoxicityproximal tubular dysfunction

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