Skip to main content
NCBI home page
The British Journal of Cancer. Supplement logoLink to The British Journal of Cancer. Supplement
. 1992 Aug;18:S30–S35.

The influence of age on nephrotoxicity following chemotherapy in children.

R Skinner 1, A D Pearson 1, L Price 1, M G Coulthard 1, A W Craft 1
PMCID: PMC2149663  PMID: 1503924

Abstract

Nephrotoxicity is an important adverse effect of chemotherapy in children. Renal function after treatment with either ifosfamide or cisplatinum in children aged 5 years or less ('younger children') was compared with that in those over 5 years ('older children'). Eighteen children (six younger, 12 older) given ifosfamide were studied after completion of chemotherapy, and 28 patients (16 younger, 12 older) were evaluated after cisplatinum. Glomerular filtration rate was measured from the plasma clearance of 51chromium-labelled edetic acid. Proximal tubular function was assessed by determination of plasma and urine calcium, phosphate, magnesium and glucose concentration; calculations of their fractional excretions, and of the renal threshold for phosphate; and measurement of urinary excretion of beta 2-microglobulin. Distal tubular function was evaluated by measurement of the early morning urine osmolality. Younger children had more severe proximal tubular toxicity than older children treated with ifosfamide, with significantly lower plasma phosphate concentrations and higher fractional excretions of glucose. However, there was no evidence of any such difference in glomerular or distal tubular damage after ifosfamide, and no difference in any aspect of renal function between younger and older children treated with cisplatinum. Increased proximal tubular toxicity after ifosfamide in younger children may have serious implications for future growth and development.

Full text

PDF
S30

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bellin S. L., Selim M. Cisplatin-induced hypomagnesemia with seizures: a case report and review of the literature. Gynecol Oncol. 1988 May;30(1):104–113. doi: 10.1016/0090-8258(88)90052-2. [DOI] [PubMed] [Google Scholar]
  2. Bianchetti M. G., Kanaka C., Ridolfi-Lüthy A., Wagner H. P., Hirt A., Paunier L., Peheim E., Oetliker O. H. Chronic renal magnesium loss, hypocalciuria and mild hypokalaemic metabolic alkalosis after cisplatin. Pediatr Nephrol. 1990 May;4(3):219–222. doi: 10.1007/BF00857658. [DOI] [PubMed] [Google Scholar]
  3. Brodehl J., Gellissen K., Weber H. P. Postnatal development of tubular phosphate reabsorption. Clin Nephrol. 1982 Apr;17(4):163–171. [PubMed] [Google Scholar]
  4. Brodehl J., Krause A., Hoyer P. F. Assessment of maximal tubular phosphate reabsorption: comparison of direct measurement with the nomogram of Bijvoet. Pediatr Nephrol. 1988 Apr;2(2):183–189. doi: 10.1007/BF00862587. [DOI] [PubMed] [Google Scholar]
  5. Burk C. D., Restaino I., Kaplan B. S., Meadows A. T. Ifosfamide-induced renal tubular dysfunction and rickets in children with Wilms tumor. J Pediatr. 1990 Aug;117(2 Pt 1):331–335. doi: 10.1016/s0022-3476(05)80557-8. [DOI] [PubMed] [Google Scholar]
  6. FETTERMAN G. H., SHUPLOCK N. A., PHILIPP F. J., GREGG H. S. THE GROWTH AND MATURATION OF HUMAN GLOMERULI AND PROXIMAL CONVOLUTIONS FROM TERM TO ADULTHOOD: STUDIES BY MICRODISSECTION. Pediatrics. 1965 Apr;35:601–619. [PubMed] [Google Scholar]
  7. Heney D., Lewis I. J., Bailey C. C. Acute ifosfamide-induced tubular toxicity. Lancet. 1989 Jul 8;2(8654):103–104. doi: 10.1016/s0140-6736(89)90341-3. [DOI] [PubMed] [Google Scholar]
  8. Knapp M. L., Hadid O. Investigations into negative interference by jaundiced plasma in kinetic Jaffé methods for plasma creatinine determination. Ann Clin Biochem. 1987 Jan;24(Pt 1):85–97. doi: 10.1177/000456328702400114. [DOI] [PubMed] [Google Scholar]
  9. Massry S. G., Friedler R. M., Coburn J. W. Excretion of phosphate and calcium. Physiology of their renal handling and relation to clinical medicine. Arch Intern Med. 1973 Jun;131(6):828–859. doi: 10.1001/archinte.131.6.828. [DOI] [PubMed] [Google Scholar]
  10. Moncrieff M., Foot A. Fanconi syndrome after ifosfamide. Cancer Chemother Pharmacol. 1989;23(2):121–122. doi: 10.1007/BF00273531. [DOI] [PubMed] [Google Scholar]
  11. Morris-Jones P. H., Craft A. W. Childhood cancer: cure at what cost? Arch Dis Child. 1990 Jun;65(6):638–640. doi: 10.1136/adc.65.6.638. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Newbury-Ecob R. A., Noble V. W., Barbor P. R. Ifosfamide-induced Fanconi syndrome. Lancet. 1989 Jun 10;1(8650):1328–1328. doi: 10.1016/s0140-6736(89)92719-0. [DOI] [PubMed] [Google Scholar]
  13. Schilsky R. L., Anderson T. Hypomagnesemia and renal magnesium wasting in patients receiving cisplatin. Ann Intern Med. 1979 Jun;90(6):929–931. doi: 10.7326/0003-4819-90-6-929. [DOI] [PubMed] [Google Scholar]
  14. Skinner R., Pearson A. D., Coulthard M. G., Skillen A. W., Hodson A. W., Goldfinch M. E., Gibb I., Craft A. W. Assessment of chemotherapy-associated nephrotoxicity in children with cancer. Cancer Chemother Pharmacol. 1991;28(2):81–92. doi: 10.1007/BF00689694. [DOI] [PubMed] [Google Scholar]
  15. Skinner R., Pearson A. D., Price L., Coulthard M. G., Craft A. W. Nephrotoxicity after ifosfamide. Arch Dis Child. 1990 Jul;65(7):732–738. doi: 10.1136/adc.65.7.732. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Skinner R., Pearson A. D., Price L., Cunningham K., Craft A. W. Hypophosphataemic rickets after ifosfamide treatment in children. BMJ. 1989 Jun 10;298(6687):1560–1561. doi: 10.1136/bmj.298.6687.1560. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Smeitink J., Verreussel M., Schröder C., Lippens R. Nephrotoxicity associated with ifosfamide. Eur J Pediatr. 1988 Nov;148(2):164–166. doi: 10.1007/BF00445929. [DOI] [PubMed] [Google Scholar]
  18. Womer R. B., Pritchard J., Barratt T. M. Renal toxicity of cisplatin in children. J Pediatr. 1985 Apr;106(4):659–663. doi: 10.1016/s0022-3476(85)80098-6. [DOI] [PubMed] [Google Scholar]
  19. de Swiet M., Dillon M. J., Littler W., O'Brien E., Padfield P. L., Petrie J. C. Measurement of blood pressure in children. Recommendations of a working party of the British Hypertension Society. BMJ. 1989 Aug 19;299(6697):497–497. doi: 10.1136/bmj.299.6697.497. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from The British Journal of Cancer. Supplement are provided here courtesy of Cancer Research UK

RESOURCES