Your browser doesn't support javascript.
loading
Aminoaciduria in the prediction of ifosfamide-induced tubulopathy after childhood cancer: a feasibility study.
Morgan, Jessica E; McKeever, Karl; Tyerman, Kay S; Henderson, Michael; Picton, Susan; Phillips, Robert S.
Afiliación
  • Morgan JE; Department of Paediatric Oncology, Leeds Teaching Hospitals NHS Trust, Leeds, UK ; Centre for Reviews and Dissemination, University of York, Leeds, UK.
  • McKeever K; Department of Paediatric Nephrology, Royal Belfast Hospital for Sick Children, Leeds, UK.
  • Tyerman KS; Department of Paediatric Nephrology, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
  • Henderson M; Department of Biochemical Genetics, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
  • Picton S; Department of Paediatric Oncology, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
  • Phillips RS; Department of Paediatric Oncology, Leeds Teaching Hospitals NHS Trust, Leeds, UK ; Centre for Reviews and Dissemination, University of York, Leeds, UK.
Article en En | MEDLINE | ID: mdl-27965825
BACKGROUND: Ifosfamide, an alkylating agent used widely in the treatment of childhood malignancy, can cause many side effects including a proximal tubulopathy. Studies suggest that aminoaciduria is seen most commonly of all the biochemical abnormalities of ifosfamide-induced tubulopathy. A recent systematic review has found a paucity of data regarding the value of early markers indicating clinically significant tubulopathy. We undertook a pilot study to determine the feasibility of examining whether patients can be risk-stratified on the basis of aminoaciduria for the development of future significant ifosfamide-induced tubulopathy, to allow the evolution of appropriate follow-up strategies. We also aimed to define accrual rates, costs and clinical demands for a future larger study. METHODS: This observational study recruited 21 patients from the Leeds Paediatric Oncology service. The medical notes of each patient were reviewed for demographic and clinical data. Simultaneous samples of blood and urine were obtained. RESULTS: The investigations in the feasibility study were acceptable to patients and were minimally demanding on both clinical and laboratory staff. Financially, the cost per patient was minimal. This study was not powered to detect significant associations with TmP/GFR (ratio of renal tubular maximum reabsorption rate of phosphate to glomerular filtration rate), growth and electrolyte supplementation. However, all patients with minimal aminoaciduria (≤2 elevated urinary amino acids) had normal TmP/GFR and no need for electrolyte supplementation. CONCLUSIONS: This pilot study has shown that a larger study is feasible and may provide clinically useful data to change current practice. This should aim to establish whether the number of abnormal amino acids or the degree of abnormality is most significant in predicting clinically significant proximal tubulopathy.
Palabras clave

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Idioma: En Revista: Pilot Feasibility Stud Año: 2016 Tipo del documento: Article Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Idioma: En Revista: Pilot Feasibility Stud Año: 2016 Tipo del documento: Article Pais de publicación: Reino Unido