RENAL-FUNCTION IN CHILDREN AND ADOLESCENTS FOLLOWING 72-G M(2) OF IFOSFAMIDE/

A detailed analysis of the renal function of 18 children and adolescen ts aged 7-20 years (median, 16 years) was performed at least 3 months following the completion of a non-platinum-containing chemotherapy reg imen with a total dose of 72 g/m(2) of ifosfamide. Ifosfamide had been given as a 1-h infusion of 1.8 g/m(2) daily for 5 days at 5- to 6-wee k intervals along with mesna uroprotection. The mean glomerular filtra tion rate (GFR) as determined by inulin clearance was 100 ml/min/1.73 m(2). Although 6 of 18 patients had GFRs below normal, the lowest was only 18% less than the lower limit of normal and would not account for any clinical compromise. The renal plasma flow and filtration fractio n were normal. Proximal tubular function evaluation revealed normal fr actional excretion (FE) of glucose; normal mean tubular maximum phosph ate reabsorption per GFR (TMP)/GFR values; high FE of urate (17%); and mild, generalized aminoaciduria in 6 of the is patients. Distal tubul ar function evaluation showed normal 24-h urinary calcium levels and F E of magnesium as well as normal urinary osmolality after water depriv ation. Two patients had mild proteinuria. The findings in this study a re encouraging in terms of the lack of clinically significant renal ab normalities observed in patients' who had received a cumulative dose o f 72 g/m(2) of ifosfamide.