Genitourinary System

Ifosfamide, carboplatin, and cisplatin can cause renal complications, including acute tubular dysfunction manifested by increased excretion of potassium, phosphorus, and magnesium. Carboplatin is less nephrotoxic than cisplatin. Ifosfamide can cause hypophosphatemic rickets. Risk factors for ifosfamide nephrotoxicity include:

• Younger age group

• Hydronephrosis

• Prior administration of cisplatin

• Cumulative dose of ifosfamide greater than 72 g/m2.

Indicators of significant Fanconi syndrome are serum glucose less than 150 mg/dL and a ratio of urine protein to urine creatinine of less than 0.2. Serum phosphate, <3.5 mg/dL; K+, <3 mEq/L; bicarbonate, <17 mEq/L; and 1+ glycosuria.

Hemorrhagic cystitis and fibrosis of the bladder can occur often after treatment with cyclophosphamide and ifosfamide, especially when the bladder is included in the radiation field. Hypoplastic kidney and renal arteriosclerosis can occur after the use of a combination of radiation therapy in a dose of 10-15 Gy with chemotherapy

Table 27-12. Evaluation of Hypothalamic-Pituitary Axis

Response to

Table 27-12. Evaluation of Hypothalamic-Pituitary Axis

Response to

Was this article helpful?

0 0

Post a comment