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首页> 外文期刊>Medical and Pediatric Oncology: The Official Journal of the American Association for Cancer Education >Development of ifosfamide-induced nephrotoxicity: prospective follow-up in 75 patients.
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Development of ifosfamide-induced nephrotoxicity: prospective follow-up in 75 patients.

机译：异环磷酰胺诱导的肾毒性的发展：75例患者的前瞻性随访。

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PURPOSE: This study was performed to describe prospectively the development and prognosis of severe ifosfamide-induced nephrotoxicity and to define the period of recommended renal follow-up after ifosfamide chemotherapy. PATIENTS AND METHODS: Renal function was followed in 75 patients after cessation of chemotherapy starting within the first year off therapy; median follow-up time was 31 months. The glomerular filtration rate was estimated by using the Schwartz formula. Proximal tubular transport capacities were evaluated for amino acids, phosphate, sodium, and glucose. In addition, serum bicarbonate level and alkaline phosphatase were measured. RESULTS: Five patients developed renal Fanconi syndrome during follow-up, and another seven patients developed a generalized subclinical tubulopathy. The latter condition always preceded Fanconi syndrome. Severe impairment of amino acid and phosphate reabsorption was seen in 28% and 17.3% of patients, respectively. Reductions in amino acid reabsorption preceded impairment of phosphate reabsorption. In patients with early impairment of phosphate reabsorption, renal prognosis was poor, whereas normal or only mildly impaired amino acid handling virtually excluded progressive tubular damage. CONCLUSIONS: Ifosfamide-induced renal tubular damage is a potentially progressive disease. Along with measurement of phosphate reabsorption, additional assessment of tubular amino acid handling is suggested, because it allows early discrimination of poor from favorable renal outcomes.
机译：目的：本研究旨在前瞻性描述严重异环磷酰胺诱导的肾毒性的发生和预后，并确定异环磷酰胺化疗后建议的肾脏随访时间。病人和方法：75例患者在停止治疗的第一年开始化疗后随访肾功能。中位随访时间为31个月。肾小球滤过率通过使用Schwartz公式估算。对氨基酸，磷酸盐，钠和葡萄糖的近端肾小管转运能力进行了评估。另外，测量血清碳酸氢盐水平和碱性磷酸酶。结果：5例患者在随访过程中发生了肾脏Fanconi综合征，另外7例患者出现了广泛的亚临床肾小管病变。后一种情况总是先于Fanconi综合征。分别有28％和17.3％的患者严重破坏了氨基酸和磷酸盐的重吸收。氨基酸重吸收的减少先于磷酸盐重吸收的损害。在磷酸盐再吸收早期受损的患者中，肾脏的预后较差，而正常或仅轻微受损的氨基酸处理实际上排除了进行性肾小管损害。结论：异环磷酰胺引起的肾小管损害是潜在的进行性疾病。除了对磷酸盐的重吸收进行测量外，还建议对管状氨基酸的处理进行其他评估，因为它可以及早区分不良肾脏预后和良好肾脏预后。

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