Unilateral nephrectomy and cisplatin as risk factors of ifosfamide-induced nephrotoxicity: analysis of 120 patients.

Rossi, Rainer; Gödde, Almut; Kleinebrand, Almud; Riepenhausen, Marianne; Boos, Joachim; Ritter, J; Jürgens, H.

doi:10.1200/jco.1994.12.1.159

Cited by 129 publications

(94 citation statements)

References 18 publications

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“…A statistically significant fall in mean GFR of 35 mL/min/1.73 m 2 was observed after completion of ifosfamide therapy [6]. The renal toxicity following ifosfamide treatment is subject to great inter-individual variability [7]. Evidence of renal damage may become apparent immediately after starting treatment or not until after the treatment is completed [1].…”

Section: Discussionmentioning

confidence: 99%

Improvement in karyomegalic interstitial nephritis three years after ifosfamide and cisplatin therapy by corticosteroid

et al. 2014

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Long-term nephrotoxicity of ifosfamide is occasionally progressive, and, in such case, there has been no specific treatment to prevent progression. It has been reported that the presence of karyomegalic interstitial nephritis, which is rare type of interstitial nephritis, may be related to ifosfamide-induced nephropathy with poor prognosis and resistant to the immunosuppressive therapy. A 15-year-old boy presented with progressive nephrotoxicity 3 years after systemic chemotherapy with ifosfamide and cisplatin for the treatment of osteosarcoma. Renal biopsy revealed the severe tubulointerstitial nephritis with tubular atrophy and focal global and segmental glomerular sclerosis. It also showed tubular epithelial cells with variably sized nuclei, some of which were massively enlarged, abnormal hyperchromatic, irregular shaped, and bizarreappearing. These morphological changes were suggestive of the histology of karyomegalic interstitial nephritis. Corticosteroid retarded the progression of nephrotoxicity. The present case is the first report, suggesting that corticosteroid was effective against the late-onset renal toxicity by ifosfamide therapy. Our case also suggests that karyomegalic interstitial nephritis may be the result of long-term nephrotoxicity of ifosfamide. Since concurrent treatment with cisplatin is one of the risk factors for ifosfamide nephrotoxicity, there is a possibility that cisplatin may have a synergetic effect with ifosfamide for producing karyomegalic interstitial nephritis.

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Section: Discussionmentioning

confidence: 99%

Improvement in karyomegalic interstitial nephritis three years after ifosfamide and cisplatin therapy by corticosteroid

et al. 2014

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“…Moreover, the benefit of including alkylating agents in the treatment of patients diagnosed with CCSK is incorporated in the UMBRELLA protocol 2 , to reduce the risk of serious renal toxicity caused by ifosfamide [39][40][41][42] as well as the occurrence of second tumours or fertility problems caused by cyclophosphamide [43][44][45] . Combining the alkylating agents ifosfamide and cyclophosphamide in an alternating setting to reduce the total cumulative dose of either drug was decided by consensus (TABLE 2).…”

Section: General Treatment Recommendationsmentioning

confidence: 99%

Rationale for the treatment of children with CCSK in the UMBRELLA SIOP–RTSG 2016 protocol

et al. 2018

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“…4 Nevertheless, high therapeutic doses of ifosfamide are associated with sever nephrotoxicity. 5 Renal toxicity is reported in 5% of ifosfamide-treated patients in the form of Fanconi syndrome. 6 This syndrome is characterized by renal glucosuria, loss of electrolytes, bicarbonate and lactate, generalized hyperaminoaciduria and lowmolecular-weight proteinuria.…”

Section: Introductionmentioning

confidence: 99%

The effects ofN-acetyl-l-cysteine on the female reproductive performance and nephrotoxicity in rats

Helal

2016

Renal Failure

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This study was designed to investigate whether the treatment with the N-acetyl-L-cysteine prior to the administration of chemotherapy drug would prevent from nephrotoxicity and the loss of reproductive performance induced from chemotherapy treatment. Female rats were divided into five equal groups of six each: 1/control group; 2/rats i.p administered saline solution; 3/rats i.p administered holoxan (50 mg/kg b.wt); 4/rats i.p administered N-acetyl-L-cysteine (160 mg/kg b.wt); 5/rats i.p administered holoxan and N-acetyl-L-cysteine at the same doses. After medications, females rats were allowed to mate with males and the pregnant rats were sacrificed on day 18 of gestation. Premating treatment with holoxan showed reduction (p50.05) in reproductive performance. Whereas administration of N-acetyl-L-cysteine prior to treatment with holoxan and then concurrently with it modulated significantly fertility index, progesterone level, decreasing postimplantation loss, resorbed fetuses and improved fetal growth. Additionally, holoxan elevated the renal nicotinamide dinucleotide phosphate (NADPH) oxidase activity, oxidative stress, renal functions and caused histological changes in renal tissue. N-Acetyl-L-cysteine treatment reduced (p50.05) renal tissue NADPH oxidase, nitric oxide, malondialdehyde and improved super oxide dismutase (SOD) depletion, elevated levels phosphate, total protein and calcium as well as prevented renal histological damages. N-Acetyl-L-cysteine can confer protection against nitrosative and oxidative stresses in renal tissue induced by holoxan by suppressing NADPH oxidase activation, malondialdehyde, nitric oxide and restoring SOD activity which led to the reduction of reactive oxygen species production and subsequently might effectively improve the gonadal hormone disturbance and reproductive functions. ARTICLE HISTORY

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Unilateral nephrectomy and cisplatin as risk factors of ifosfamide-induced nephrotoxicity: analysis of 120 patients.

Abstract: Ifosfamide chemotherapy should probably be restricted in patients after unilateral nephrectomy.

Cited by 129 publications

References 18 publications

Improvement in karyomegalic interstitial nephritis three years after ifosfamide and cisplatin therapy by corticosteroid

Improvement in karyomegalic interstitial nephritis three years after ifosfamide and cisplatin therapy by corticosteroid

Rationale for the treatment of children with CCSK in the UMBRELLA SIOP–RTSG 2016 protocol

The effects ofN-acetyl-l-cysteine on the female reproductive performance and nephrotoxicity in rats

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