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Acute changes in urine protein excretion may predict chronic ifosfamide nephrotoxicity: a preliminary observation

Lookup NU author(s): Professor Roderick Skinner, Dr Andrew Hall, Professor Andrew Pearson


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Purpose: To evaluate proteinuria occurring early after ifosfamide therapy and to assess the use of changes in proteinuria in the prediction of severe chronic nephrotoxicity. Methods: One-dimensional sodium dodecyl sulphate polyacrylamide gel electrophoresis was used to characterize urine protein excretion in 12 children with solid tumours before and after the first course of ifosfamide treatment, and in 24 healthy children. Chronic nephrotoxicity was evaluated at 6 months after ifosfamide treatment and graded as none, mild, moderate or severe. Results: Urine from healthy children and from 10 of 12 patients before ifosfamide therapy showed a protein band with a molecular weight (95.4 kDa) corresponding to that of Tamm-Horsfall protein but no lower molecular weight proteins. After the first course of ifosfamide this 95.4-kDa protein was lost in six of ten patients with a concomitant appearance of a low molecular weight proteinuria (< 70 kDa) in eight. Tamm-Horsfall protein was lost in two of five patients who subsequently developed no or mild nephrotoxicity and in four of five patients who subsequently developed moderate or severe nephrotoxicity. Conclusions: Early subclinical changes in urine protein excretion after ifosfamide, manifested by a loss of Tamm-Horsfall protein excretion, may be predictive of subsequent chronic nephrotoxicity.

Publication metadata

Author(s): MacLean FR, Skinner R, Hall AG, English M, Pearson ADJ

Publication type: Article

Publication status: Published

Journal: Cancer Chemotherapy and Pharmacology

Year: 1998

Volume: 41

Issue: 5

Pages: 413-416

Print publication date: 25/02/1998

ISSN (print): 0344-5704

ISSN (electronic): 1432-0843


DOI: 10.1007/s002800050759

PubMed id: 9523738


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