Clinical Case 56: Answers and Summary

NAME THE AGENT: 45 Y OLD MALE WITH SARCOMA GETS WORSENING RENAL FAILURE AFTER CHEMOTHERAPY X. LABS SHOW PERSISTENT HYPOURICEMIA, HYPOKALEMIA, HYPOPHOSPHATEMIA AND NON GAP ACIDOSIS AS WELL. URINE PH VALUES ARE IN 6-7 RANGE.

The case presents a fanconi's syndrome. This is classically seen in Ifosfamide toxicity. This can also be seen in cisptatin or methotrexate toxicity. Carmustine cause a more slow interstitial injury. Cetuximab is usually associated with pure hypomagnesemia.  Sunitinib is a tyrosine kinase inhibitor that can cause thrombotic microangiopathy, proteinuria or interstitial disease. A concept map of chemotherapy induced kidney disease can be found here.