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Growth impairment after ifosfamide‐induced nephrotoxicity in children
Author(s) -
Stöhr Wolfgang,
Patzer Ludwig,
Paulides Marios,
Kremers Anja,
Beck JörnDirk,
Langer Thorsten,
Rossi Rainer
Publication year - 2007
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.20920
Subject(s) - medicine , ifosfamide , nephrotoxicity , renal function , tubulopathy , urology , nephrology , fanconi syndrome , kidney disease , surgery , chemotherapy , kidney , cisplatin
Background The goal of this study was to analyze long‐term consequences of ifosfamide‐induced nephrotoxicity on growth and renal function in children treated for cancer. Procedure In a retrospective study, departments for pediatric oncology and nephrology in Germany, Austria, and Switzerland were asked to report patients with serious long‐term nephrotoxicity after ifosfamide‐treatment. Data at first appearance of renal dysfunction and at the last renal examination were collected using a standardized questionnaire. Results Fifty‐nine patients with tubulopathy (35 severe, 24 moderate) following ifosfamide therapy were eligible for analysis of long‐term outcome (median follow‐up 4 years, range 1.1 to 12.9). Median height standard deviation score was significantly reduced at renal diagnosis, and at last renal examination (−1.7 and −2.1 respectively, P < 0.01 at each point in time). Patients with tubulopathy also had stunted growth in comparison with a control group of cancer patients without renal disease (mean difference at last examination: 7.3 cm (95% confidence interval: 2.5 to 12.1 cm). In patients with severe tubulopathy, glomerular filtration rate deteriorated significantly over time. End‐stage renal disease was reported in one patient only, not solely caused by ifosfamide. Conclusion Depending on the extent of tubular dysfunction, patients with ifosfamide‐induced nephrotoxicity experienced significant growth impairment and a slow decline in glomerular filtration rate. Pediatr Blood Cancer 2007;48:571–576. © 2006 Wiley‐Liss, Inc.