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Nephrotic Syndrome and Acute Renal Failure Apparently Induced by Sunitinib

Ying-Shou Chen1, Chien-Liang Chen, Jyh-Seng Wang

  • 1Division of Nephrology, Department of Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.

Case Reports in Oncology
|August 26, 2010
PubMed

Insights

Sunitinib may cause nephrotic syndrome and acute kidney injury in cancer patients. Early monitoring of kidney function and proteinuria is crucial to prevent severe renal damage during sunitinib therapy.

Area of Science:

  • Nephrology
  • Oncology
  • Pharmacology

Background:

  • Sunitinib is a tyrosine kinase inhibitor used for metastatic renal cell carcinoma.
  • Nephrotic syndrome and acute renal failure are serious potential adverse events.
  • This case highlights a severe adverse drug reaction in a patient undergoing sunitinib treatment.

Observation:

  • A 67-year-old male with metastatic renal cell carcinoma developed nephrotic syndrome and acute kidney injury after 3 weeks of sunitinib.
  • Symptoms included proteinuria, edema, and significant weight gain, with other causes excluded.
  • The Naranjo scale indicated a high probability of a drug-induced adverse event.

Findings:

  • Despite sunitinib discontinuation, the patient's condition worsened, requiring hemodialysis.
  • Renal biopsy revealed ischemic acute tubular necrosis with minimal change nephropathy.
  • This suggests a direct link between sunitinib and severe renal pathology.

Implications:

  • Nephrologists and oncologists must be aware of sunitinib-induced nephrotic syndrome and acute tubular necrosis.
  • Regular monitoring of serum creatinine and proteinuria is recommended for patients on sunitinib.
  • Early detection and intervention are key to mitigating renal damage from this drug.

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