Fanconi Syndrome
Global failure of proximal tubule reabsorption — glucosuria, phosphaturia and acidosis, classically from ifosfamide.
Agents’ overall severity
Each agent’s whole-drug severity grade, not the severity of this lesion specifically — an agent whose signature injury is elsewhere can still be graded severe here.
Agents’ overall reversibility
Agents’ onset window
How soon each agent’s kidney toxicity typically appears — a whole-drug tempo, not specific to this lesion.
Real-world reporting for this lesion
FAERS across all lesions →Agents with a disproportionate FAERS reporting signal for fanconi syndrome (reporting odds ratio with a 95% CI lower bound above 1) — a spontaneous-reporting signal, not incidence or proven causation. FAERS carries reporting and indication biases and has no denominator.
Documented in the atlas profile and carrying a FAERS signal — the strongest claim the atlas makes.
Documented in a profile with no reporting signal. Mostly expected: naming this lesion on a report can require a biopsy, and silence is not evidence against the literature.
A real reporting signal that is not evidence for this drug-lesion pair: no MedDRA term names it, the naming subset asked alone came back flat, or the 2026-08 review attributed the reporting to the population, co-therapy, or class-level literature.
The terms that name this lesion are disproportionate, but no profile documents it for that agent. Most are echoed by a sibling agent in the same class. Leads for review, never lesions the atlas claims.
23 agents with a significant FANC reporting signal.
Management approach
Full framework →Supportive electrolyte and acid–base repletion; often partially irreversible, so prevention (cumulative-dose limits) matters.
Drug-level levers
- Hold or avoid further exposure once Fanconi features appear.
- Respect cumulative-dose limits; use caution in young children and after prior cisplatin exposure.
Pharmacologic toolkit
- Electrolyte repletion — Phosphate, bicarbonate or citrate (for proximal renal tubular acidosis), and potassium replacement.
- Supportive — Monitor growth in children; some proximal tubular dysfunction persists long-term.
When to biopsy
Usually clinical (glucosuria with normal serum glucose, phosphaturia, proximal RTA); biopsy not routinely required.
Monitoring
- · Phosphate, bicarbonate, potassium, glucose
- · Growth in children
Educational use only. Educational synthesis of the published literature — not a treatment protocol, dosing guide, or medical advice. Regimens and agents shown are illustrative of what the literature describes; verify against current guidelines (ASON / KDIGO / ASCO / NCCN) and individualize to the patient. Using this site creates no clinician–patient relationship.
What the guidelines say
All guidelines →Society and consensus recommendations that speak to fanconi syndrome.
Each recommendation below is this atlas's faithful summary of the source, not a quotation from it — follow the PubMed link for the wording the society published. Summaries may be superseded; consult the current full text and individualize to the patient.
Offending agents
Signature offenders
3Agents for which fanconi syndrome is the defining renal lesion.