Reversible Proximal Renal Tubular Dysfunction after One-Time Ifosfamide Exposure.
- Author:
Young Il KIM
1
;
Ju Young YOON
;
Jun Eul HWANG
;
Hyun Jeong SHIM
;
Woo Kyun BAE
;
Sang Hee CHO
;
Ik Joo CHUNG
Author Information
1. Department of Hematology-Oncology, Chonnam National University Medical School, Gwangju, Korea. drwookyun@chonnam.ac.kr
- Publication Type:Case Report
- Keywords:
Ifosfamide;
Proximal kidney tubules;
Fanconi syndrome
- MeSH:
Adult;
Aged;
Cystitis;
Diabetes Mellitus, Type 2;
Diabetic Nephropathies;
Doxorubicin;
Drug Toxicity;
Dysuria;
Fanconi Syndrome;
Glomerular Filtration Rate;
Hematuria;
Humans;
Ifosfamide;
Kidney Tubules, Proximal;
Male;
Mesna;
Sarcoma
- From:Cancer Research and Treatment
2010;42(4):244-246
- CountryRepublic of Korea
- Language:English
-
Abstract:
The alkylating agent ifosfamide is an anti-neoplastic used to treat various pediatric and adult malignancies. Its potential urologic toxicities include glomerulopathy, tubulopathy and hemorrhagic cystitis. This report describes a case of proximal renal tubular dysfunction and hemorrhagic cystitis in a 67-year-old male given ifosfamide for epitheloid sarcoma. He was also receiving an oral hypoglycemic agent for type 2 diabetes mellitus and had a baseline glomerular filtration rate of 51.5 mL/min/1.73 m2. Despite mesna prophylaxis, the patient experienced dysuria and gross hematuria after a single course of ifosfamide plus adriamycin. The abrupt renal impairment and serum/urine electrolyte imbalances that ensued were consistent with Fanconi's syndrome. However, normal renal function and electrolyte status were restored within 14 days, simply through supportive measures. A score of 8 by Naranjo adverse drug reaction probability scale indicated these complications were most likely treatment-related, although they developed without known predisposing factors. The currently undefined role of diabetic nephropathy in adult ifosfamide nephrotoxicity merits future investigation.
