Ifosfamide induced renal damage comes in 6 flavors. The toxic agent is metabolite chloroacetaldehyde rather than the parent drug to the tubular cells of the kidney.
1. Pure hypophosphatemia – this is due to direct proximal damage
2. Fanconi syndrome
3. Pure renal potassium wasting syndrome leading to hypokalemia
5. Distal RTA
6. Nephrogenic Diabetes insipidus