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Related Experiment Videos

Concentrating capacity in ifosfamide-induced severe renal dysfunction

R Rossi1, A Gödde, A Kleinebrand

  • 1University Children's Hospital, Münster, Germany.

Renal Failure
|September 1, 1995
PubMed
Summary

Defective renal concentrating capacity is rare in ifosfamide-induced renal dysfunction, primarily affecting patients with overt Fanconi syndrome. Early evaluation of concentrating capacity and sodium handling is crucial to prevent dehydration risks.

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Area of Science:

  • Nephrology
  • Oncology
  • Pharmacology

Background:

  • Ifosfamide chemotherapy can cause renal dysfunction, including Fanconi syndrome.
  • Previous studies suggest subclinical renal impairment may present with low urine osmolarity.
  • The frequency of impaired concentrating capacity in ifosfamide-induced Fanconi syndrome requires further investigation.

Purpose of the Study:

  • To determine the frequency of defective renal concentrating capacity in patients with ifosfamide-induced Fanconi syndrome or severe proximal tubular dysfunction.
  • To assess the relationship between overt Fanconi syndrome and impaired urinary concentrating ability.

Main Methods:

  • Evaluated 7 patients with overt Fanconi syndrome and 5 with subclinical tubulopathy.
  • Measured urinary osmolarity after overnight fasting and DDAVP (1-D-amino-8-D-arginine vasopressin) administration.

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  • Assessed proximal tubular solute reabsorption and glomerular filtration rate.

    • Main Results:

    • Five of 7 patients with overt Fanconi syndrome showed decreased urinary osmolarity in at least one test.
    • No patients with subclinical tubular damage exhibited decreased osmolarity.
    • Increased sodium excretion was observed in 4 patients with overt Fanconi syndrome.

    Conclusions:

    • Impaired renal concentrating capacity is uncommon in ifosfamide-induced renal dysfunction and is limited to patients with overt Fanconi syndrome.
    • Patients with overt Fanconi syndrome require evaluation of concentrating capacity and sodium handling.
    • Decreased concentrating capacity and increased sodium excretion increase dehydration risk.