Nephrotoxicity associated with ifosfamide.

Three patients developed a Fanconi syndrome with impairment of glomerular function (endogenous creatinine clearance 30-60 ml/min per 1.73 m2) during and/or after treatment with ifosfamide according to the SIOP-MMT 84 protocol in which ifosfamide was given in a dose of 3000 mg/m2 every 4 weeks over a 10-month period. The need for early substitution therapy in patients with the Fanconi syndrome is stressed. The renal lesions in our patients were irreversible.