title: [End-stage renal disease after sarcoma therapy - case 3/2014].
abstract: METHODS
  A 67-year-old male patient developed progressive renal failure following successful treatment of a soft tissue sarcoma that comprised surgical resection after neoadjuvant radiochemotherapy with the application of doxorubicin (cumulative dose 180 mg/m²) and ifosfamide (cumulative dose 33 g/m²).
  
  
  METHODS
  Plasma creatinine concentration was elevated to 4.5 mg/dl. Upon detection of glucosuria and α1-microglobulinuria renal biopsy was performed.
  
  
  METHODS
  Histologic analysis revealed massively injured tubules that could be explained by a toxic effect of ifosfamide. Glomeruli were not affected and appeared normal. After two months of conservative therapy, the patient developed an uremic syndrome requiring hemodialysis. Ever since kidney function did not recover albeit preserved diuresis.
  
  
  CONCLUSIONS
  Ifosfamide can cause end-stage renal disease by a tubulotoxic effect that may be the result of a selective intracellular uptake into the proximal tubule via the human organic cation transporter 2 (OCT2).
authors.affiliation: Medizinische Klinik, Universitätsklinikum Tübingen.
authors.forename: Dorothea
authors.initials: D
authors.lastname: Baumann
authors.affiliation: Pathologisches Institut, Universitätsklinikum Erlangen.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Amann
authors.affiliation: Medizinische Klinik D, Experimentelle Nephrologie, Universitätsklinikum Münster.
authors.forename: Eberhard
authors.initials: E
authors.lastname: Schlatter
authors.affiliation: Medizinische Klinik D, Experimentelle Nephrologie, Universitätsklinikum Münster.
authors.forename: Giuliano
authors.initials: G
authors.lastname: Ciarimboli
authors.affiliation: Medizinische Klinik, Universitätsklinikum Tübingen.
authors.forename: Hans-Georg
authors.initials: HG
authors.lastname: Kopp
authors.affiliation: Medizinische Klinik, Universitätsklinikum Tübingen.
authors.forename: Martin
authors.initials: M
authors.lastname: Müller
authors.affiliation: Orthopädische Klinik, Universitätsklinikum Tübingen.
authors.forename: Torsten
authors.initials: T
authors.lastname: Kluba
authors.affiliation: Pathologisches Institut, Universitätsklinikum Tübingen.
authors.forename: Gellert
authors.initials: G
authors.lastname: Bakos
authors.affiliation: Dialysezentrum Filderstadt.
authors.forename: Isabell
authors.initials: I
authors.lastname: Steinke
authors.affiliation: Medizinische Klinik, Universitätsklinikum Tübingen.
authors.forename: Hanno
authors.initials: H
authors.lastname: Bunz
authors.affiliation: Medizinische Klinik, Universitätsklinikum Tübingen.
authors.forename: Peter
authors.initials: P
authors.lastname: Weyrich
authors.affiliation: Medizinische Klinik, Universitätsklinikum Tübingen.
authors.forename: Ferruh
authors.initials: F
authors.lastname: Artunc
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use*; D003937:Diagnosis, Differential; D004317:Doxorubicin / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D007069:Ifosfamide / Q000009:adverse effects / Q000627:therapeutic use; D007676:Kidney Failure, Chronic / Q000139:chemically induced* / Q000175:diagnosis*; D008297:Male; D012509:Sarcoma / Q000150:complications / Q000188:drug therapy*; D012983:Soft Tissue Neoplasms / Q000150:complications / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D004317:Doxorubicin; D007069:Ifosfamide