[Nephropathy in patients treated with ifosfamide]

Area of Science:

• Pediatric Oncology
• Nephrology
• Clinical Pharmacology

Background:

• Ifosfamide is a widely used chemotherapeutic agent for childhood malignancies.
• High-dose Ifosfamide administration is associated with potential renal toxicity.
• Understanding the spectrum and frequency of Ifosfamide-induced nephropathy is critical.

Observation:

• A study was conducted between 1987-1992 at the Department of Pediatric Oncology, Child Health Center, Miskolc.
• Seven patients with childhood malignancy received high-dose Ifosfamide via different protocols.
• Nephrotoxicity developed in five out of the seven patients studied.

Findings:

• Manifestations of renal tubular dysfunction included hypochloremic acidosis, glucosuria, and aminoaciduria.
• Low serum bicarbonate and phosphate concentrations were observed in affected patients.
• Two patients developed Ifosfamide-induced rickets requiring continuous bicarbonate and calcitriol substitution.

Implications:

• The frequency of Ifosfamide nephropathy highlights the need for vigilant monitoring.
• Prospective monitoring of serum and urinary abnormalities can facilitate early detection of tubulopathy.
• Early detection allows for timely initiation of replacement therapy to manage renal complications.