RENAL DYSFUNCTIONS SECONDARY TO IFOSFAMIDE IN CHILDREN

With the increasing use of ifosfamide in pediatric tumors, nephrotoxicity became the point of interest because it may cause chronic morbidity. In this study, the renal glomerular and tubular functions of 18 cases with solid tumors aged between 3-14 years (median 8) who were treated with ifosfamide were investigated. For this purpose, routine blood urea, creatinin, calcium, phosporus, electrolytes, urinary creatinine, phosphorus, glycose, protein, and urinary retinal binding protein and beta-2 microglobulin were evaluated. Except for a patient who had hypophosphatemia, phosphaturia, and proteinuria, all the cases had normal blood biochemisty, creatinine clearance, tubular phosphate reabsorbtion; and none had proteinuria, hematuria, or glycosuria. Inspite of these findings, urine beta-2 microglobulin and retinol binding protein were found to be high in 6 patient. In correlation with the increasing cumulative dose of ifosfamide (54-126 gr/m2) urinary retinol binding protein and beta-2 microglobulin of patients who are treated with ifosfamide may predict the existence of renal toxicity even if other routine renal function tests are normal. Thus, the periodic evaluation of urinary beta-2 microglobulin and retinol binding protein in patients receiving chemotherapy containing ifosfamide is recommended.