Incidence and etiology of ifosfamide nephrotoxicity: Report of a meeting held in Rhodes, Greece, October 3, 1991, sponsored by Asta Medica, Frankfurt, Germany

Abstract

The nephrotoxic potential of ifosfamide is now clearly recognized but the true incidence is unknown and risk factors are uncertain. There are, as yet, few studies which systemically explore these issues although many centers have collected data from patients receiving ifosfamide. These support the need for collaborative studies to look at the influence of probable risk factors such as age, cumulative/dose, schedule, and exposure to other nephrotoxic drugs. The ability to detect acute subclinical changes in renal function may provide the opportunity to predict subsequent clinical toxicity. The consensus of opinion recorded so far provides the basis of recommendations for future studies.

Renal function following combination chemotherapy with ifosfamide and cisplatin in patients with osteogenic sarcoma

“…This was attributed to the concomitant use of platinum derivatives, since this cumulative ifosfamide dose is generally not associated with significant tubular toxicity [17]. Other investigators also described potentiation of ifosfamide nephrotoxicity by previous or concomitant use of cisplatin [5,9,12,18].…”

Ifosfamide‐induced nephrotoxicity in 593 sarcoma patients: A report from the Late Effects Surveillance System

“…In larger studies severe nephrotoxicity occurred in up to 11% of patients 9,13,19–22. Frequency of subclinical tubular dysfunctions was much higher, concerning up to 90% of single parameters 22,23. However, definition and grading of nephrotoxicity varied much, which complicates comparisons of the different studies.…”

Growth impairment after ifosfamide‐induced nephrotoxicity in children

“…In large studies, severe nephrotoxicity occurred in up to 11% of patients treated with ifosfamide 10,14,21–24. The frequency of subclinical tubular dysfunctions was much higher, up to 90% in single laboratory parameters 24,25. Cumulative ifosfamide dose 10,23,24, concomitant cisplatin therapy 21,23,26, and unilateral nephrectomy 26 have been identified as risk factors for ifosfamide‐induced nephrotoxicity.…”