Long term renal toxicity of ifosfamide in adult patients – 5year data

Farry, James K.; Flombaum, Carlos D.; Latcha, Sheron

doi:10.1016/j.ejca.2012.03.009

Cited by 37 publications

(29 citation statements)

References 11 publications

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“…Adriamycin and ifosfamide remain candidate chemotherapy drugs for treating soft tissue tumors (27). Elderly patients have been reported to suffer reduced cardiac function and renal dysfunction in response to chemotherapy (28,29). Therefore, it is thought that the use of systemic chemotherapy should be limited to elderly patients free of any health problems, due to reduced physiologic function.…”

Section: Discussionmentioning

confidence: 99%

Prognostic factors for elderly patients with primary malignant bone and soft tissue tumors

et al. 2015

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Section: Discussionmentioning

confidence: 99%

Prognostic factors for elderly patients with primary malignant bone and soft tissue tumors

et al. 2015

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“…In a recent report, Farry et al . did a long-term assessment of ifosfamide-related renal toxicity in adult patients and reported a steady decline in the estimated GFR although none of the patients progressed to end-stage renal disease [84]. Given the development of renal toxicity after completion of ifosfamide therapy, it has been suggested that patients should be followed for the development of proximal RTA [85, 86].…”

Section: Drug-induced Proximal Rtamentioning

confidence: 99%

Proximal renal tubular acidosis: a not so rare disorder of multiple etiologies

Haque

Ariceta

Batlle

2012

Nephrology Dialysis Transplantation

147

101

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Proximal renal tubular acidosis (RTA) (Type II RTA) is characterized by a defect in the ability to reabsorb HCO3 in the proximal tubule. This is usually manifested as bicarbonate wastage in the urine reflecting that the defect in proximal tubular transport is severe enough that the capacity for bicarbonate reabsorption in the thick ascending limb of Henle's loop and more distal nephron segments is overwhelmed. More subtle defects in proximal bicarbonate transport likely go clinically unrecognized owing to compensatory reabsorption of bicarbonate distally. Inherited proximal RTA is more commonly autosomal recessive and has been associated with mutations in the basolateral sodium-bicarbonate cotransporter (NBCe1). Mutations in this transporter lead to reduced activity and/or trafficking, thus disrupting the normal bicarbonate reabsorption process of the proximal tubules. As an isolated defect for bicarbonate transport, proximal RTA is rare and is more often associated with the Fanconi syndrome characterized by urinary wastage of solutes like phosphate, uric acid, glucose, amino acids, low-molecular-weight proteins as well as bicarbonate. A vast array of rare tubular disorders may cause proximal RTA but most commonly it is induced by drugs. With the exception of carbonic anhydrase inhibitors which cause isolated proximal RTA, drug-induced proximal RTA is associated with Fanconi syndrome. Drugs that have been recently recognized to cause severe proximal RTA with Fanconi syndrome include ifosfamide, valproic acid and various antiretrovirals such as Tenofovir particularly when given to human immunodeficiency virus patients receiving concomitantly protease inhibitors such as ritonavir or reverse transcriptase inhibitors such as didanosine.

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“…For example, survivors of childhood cancers had significantly lower eGFRs in adulthood if they had received high-dose cisplatin (83 vs 101, p =0.004) or high-dose ifosfamide (88 vs 98, p =0.02) than those who had not received such treatments 66. Ifosfamide treatment of solid tumors is also associated with long-term nephrotoxicity in adults 67. Ifosfamide can enter the kidney tubules via organic cation transporters and cause proximal tubular injury.…”

Section: Considering Renal Risk While Managing Cancermentioning

confidence: 99%

Considering renal risk while managing cancer

Shahinian¹,

Bahl²,

Niepel³

et al. 2017

CMAR

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Renal function is an important consideration in the management of patients with advanced cancer. There is a reciprocal relationship between cancer and the kidney: chronic kidney disease can increase the risk of developing cancer, and patients with cancer often experience renal impairment owing to age, disease-related factors and nephrotoxic treatments. As therapies for cancer continue to improve, patients are living longer with their disease, potentially extending the period over which they are susceptible to long-term complications. Furthermore, secondary symptoms, such as bone metastases or infections, may arise that will require treatment. Certain treatments, including chemotherapy, antibiotics and some bone-targeted agents, are nephrotoxic and may require dose modifications or interruptions to prevent renal injury. Nephrologists should play a key role in the identification and management of renal impairment in patients with cancer. Furthermore, they may be able to provide advice on protecting the kidneys in instances where nephrotoxic agents require dose reductions or interruptions, and when novel therapies or combinations are used. Collaboration between oncologists and nephrologists is important to optimal patient management. This article reviews the relationship between cancer and kidney disease and examines the treatments that may impact kidney function. Considerations for monitoring renal function are also discussed.

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Long term renal toxicity of ifosfamide in adult patients – 5year data

Cited by 37 publications

References 11 publications

Prognostic factors for elderly patients with primary malignant bone and soft tissue tumors

Prognostic factors for elderly patients with primary malignant bone and soft tissue tumors

Proximal renal tubular acidosis: a not so rare disorder of multiple etiologies

Considering renal risk while managing cancer

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