The growing pains of ifosfamide

Author:

Sprangers Ben12ORCID,Lapman Sebastian3

Affiliation:

1. Department of Microbiology, Immunology and Transplantation, Laboratory of Molecular Immunology, Rega Institute, KU Leuven, Leuven, Belgium

2. Division of Nephrology, University Hospitals Leuven, Leuven, Belgium

3. Division of Onconephrology, Sanatorio Modelo de Caseros and Henry Moore Institute, Buenos Aires, Argentina

Abstract

Abstract Ifosfamide is a commonly used chemotherapeutic known to have numerous adverse kidney manifestations. In this issue of Clinical Kidney Journal, Ensergueix et al. report a multicentric observational retrospective French study on 34 adult patients with tubular dysfunction and /or kidney dysfunction following ifosfamide treatment. Of these patients, 18% had isolated proximal tubular dysfunction, 14% had isolated acute kidney injury (AKI), 18% had isolated chronic kidney disease (CKD) and 50% had a combination of proximal tubular dysfunction and AKI. Concomitant treatment with cisplatin was identified as a risk factor for the development of AKI, and cisplatin and age were associated with estimated glomerular filtration rate at last follow-up. Interestingly, the cumulative dose of ifosfamide was not associated with renal outcomes. This report highlights the need for additional studies on the prevalence, spectrum and management of ifosfamide-associated nephrotoxicity and clearly demonstrates that patients who received ifosfamide should be followed long term to detect proximal tubular dysfunction and CKD early.

Funder

Research Foundation Flanders

Publisher

Oxford University Press (OUP)

Subject

Transplantation,Nephrology

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4. Severe, irreversible renal failure after ifosfamide treatment. A clinicopathologic report of two patients;Berns;Cancer,1995

5. Drug-induced renal Fanconi syndrome;Hall;QJM,2014

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