Lethal anuria complicating high dose ifosfamide chemotherapy in a breast cancer patient with an impaired renal function.
A sixty-year-old woman with advanced breast cancer, previously treated with cisplatin, developed an irreversible lethal renal failure with anuria, the day after 5 g/m2 bolus ifosfamide. Postrenal failure was excluded by echography. A prerenal component could have contributed to renal failure because of a transient hypotension, due to an increasing ascitis, occurring just before anuria. However, correction of the hemodynamic parameters did not improve renal function. Ifosfamide is a known nephrotoxic drug with demonstrated tubulopathies. We strongly suspect that this lethal anuria was mainly due to ifosfamide, occurring in a patient having received previous cisplatin chemotherapy and with poor kidney perfusion due to transient hypotension. We recommend careful use of ifosfamide in patients pretreated with nephrotoxic chemotherapy and inadequate renal perfusion.
Richard
V
V
Service de Médecine Interne, Institut Jules Bordet, Bruxelles.
Piccart
M
M
Paridaens
R
R
Sculier
J P
JP
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001002:Anuria / Q000139:chemically induced*; D001943:Breast Neoplasms / Q000150:complications / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage / Q000009:adverse effects*; D007684:Kidney Tubules / Q000187:drug effects; D008875:Middle Aged
D007069:Ifosfamide