Consult Rounds: Ifosfamide Toxicity

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