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[Ifosfamide-induced nephrotoxicity]

R Rossi1, B Rath, K Ullrich

  • 1Allgemeine Pädiatrie, Universitäts-Kinderklinik Münster.

Monatsschrift Kinderheilkunde : Organ Der Deutschen Gesellschaft Fur Kinderheilkunde
|July 1, 1993
PubMed
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Ifosfamide chemotherapy can cause subclinical kidney tubule damage (tubulopathy) in many patients, often leading to irreversible dysfunction. Cisplatin combination therapy exacerbates this Ifosfamide-induced nephrotoxicity.

Area of Science:

  • Nephrology
  • Oncology
  • Pharmacology

Background:

  • Acquired De-Toni-Debre-Fanconi-Syndromes are reported following Ifosfamide chemotherapy.
  • Prognosis for renal function is often poor in affected patients.
  • Subclinical tubulopathies and their prognosis require further investigation.

Purpose of the Study:

  • Evaluate the frequency of subclinical tubulopathies post-Ifosfamide therapy.
  • Assess the influence of cumulative Ifosfamide dose and other risk factors.
  • Determine the prognosis of established tubular dysfunction.

Main Methods:

  • Examined 79 patients 3+ months after Ifosfamide, Ifosfamide+Cisplatin, or Cisplatin regimens.
  • Assessed glomerular and tubular function via creatinine-clearance, protein/enzyme excretion, and tubular reabsorption.

Related Experiment Videos

  • Measured transferrin, immunoglobulin G, Alpha-1-microglobulin, NAG, phosphate, and amino acids.

    • Main Results:

    • Renal hyperaminoaciduria was most common; no dose-response for phosphate reabsorption.
    • 10.5% of patients had reduced GFR and glomerular proteinuria.
    • Half of patients exhibited tubular dysfunction, with impaired phosphate reabsorption often irreversible. Cisplatin worsened Ifosfamide-induced tubulopathy.

    Conclusions:

    • High proportion of patients develop subclinical tubulopathy after Ifosfamide.
    • Ifosfamide nephrotoxicity is worsened by Cisplatin and frequently irreversible.
    • Further research needed on risk groups, prognosis, and pathomechanisms of Ifosfamide nephrotoxicity.