This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Goren, M. P. Articles by Viar, M. J. Search for Related Content PubMed PubMed Citation Articles by Goren, M. P. Articles by Viar, M. J.

Mesna Excretion and Ifosfamide Nephrotoxicity in Children¹

Departments of Pathology and Laboratory Medicine [M. P. G., R. K. W., M. J. V.] and Hematology-Oncology [M. P. G., C. B. P., W. H. M.], Division of Biostatistics [R. K. D.], St. Jude Children's Research Hospital, Memphis, Tennessee 38105, and Departments of Pathology [M. P. G.] and Pediatrics [C. B. P., W. H. M.], University of Tennessee-Memphis, Memphis, Tennessee 38103

To characterize the excretion of 2-mercaptoethanesulfonate sodium (mesna) administered by intermittent infusion, urinary concentrations of mesna and its corresponding inactive disulfide were measured during 50 courses of ifosfamide (1.6 g/m² for 5 days) and mesna (400 mg/m² at 0.25, 4, and 6 h after each ifosfamide dose) administered i.v. to 19 patients. Some patients had previously received nephrotoxic therapy that might influence the excretion of mesna and its associated uroprotective effects. The median urinary free thiol concentration increased to 3 mM by 1 h after mesna infusion, declining to background levels by 4 h. The rate of mesna excretion correlated with the creatinine clearance rate in a subset of six patients. The proportion of mesna recovered in urine within 4 h after infusion was lower (P < 0.05) in children who had evidence of preexisting renal tubular damage. Ifosfamide-induced tubular proteinuria was associated with lower urinary mesna recovery. Low urinary mesna concentrations indicated potentially subtherapeutic renal tubular levels. However, ifosfamide nephrotoxicity was subclinical and is not necessarily linked to differences in mesna excretion.

¹ Supported in part by NIH Grant CA-49529, Childhood Solid Tumor Program Project Grant CA-23099, Cancer Center (Core) Grant CA-21765, and the American Lebanese Syrian Associated Charities.

² To whom requests for reprints should be addressed, at St. Jude Children's Research Hospital, P. O. Box 318, Memphis, TN 38101.

³ Present address: Ciba Corning Diagnostics, 132 Artino, Oberlin, OH 44074.

Received 3/11/88. Revised 8/17/89. Accepted 9/21/89.