Ifosfamide

Source: Late Effects of Treatment for Childhood Cancer (PDQ®)–Health Professional Version, National Cancer Institute.

Source updated: April 14, 2025 · Captured 2026-09-09.

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Context: Late Effects of the Urinary System / Therapy-Related Factors Affecting the Kidney / Chemotherapy

Ifosfamide can also cause glomerular and tubular toxicity, with renal tubular acidosis and Fanconi syndrome, a proximal tubular defect characterized by impairment of resorption of glucose, amino acids, phosphate, and bicarbonate.

The DCCSS-LATER 2 kidney analysis, a nationwide cross-sectional cohort study, evaluated 1,024 survivors (aged 18 years or older at the time of the study) who had received potentially nephrotoxic therapy for long-term tubular dysfunction. In multivariable risk analysis, after a median follow-up of 25.5 years, ifosfamide was associated with potassium loss (OR, 2.4) and phosphate loss (OR, 2.3) (with cumulative dose >42 g/m2).[6]

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Ifosfamide doses greater than 60 g/m2, age younger than 5 years at treatment, and combination with cisplatin and carboplatin increase the risk of ifosfamide-associated renal tubular toxicity.[18-20]

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