Ifosfamide induced renal damage comes in 6 flavors. The toxic agent is metabolite chloroacetaldehyde rather than the parent drug to the tubular cells of the kidney.
1. Pure hypophosphatemia – this is due to direct proximal damage
2. Fanconi syndrome
3. Pure renal potassium wasting syndrome leading to hypokalemia
4. ATN
5. Distal RTA
6. Nephrogenic Diabetes insipidus
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