Kidney injury during VEGF inhibitor therapy

Area of Science:

• Nephrology
• Oncology
• Pharmacology

Background:

• Antiangiogenic therapy targeting vascular endothelial growth factor (VEGF) or its receptor (VEGFR) is effective for cancers like renal cell carcinoma (RCC).
• These therapies can cause adverse renal effects, ranging from mild proteinuria and hypertension to nephrotic syndrome and renal insufficiency.

Purpose of the Study:

• To review the spectrum of kidney injuries associated with anti-VEGF therapy.
• To highlight the importance of recognizing and managing renal toxicities from these cancer treatments.

Main Methods:

• Review of existing literature on anti-VEGF therapy-induced kidney injury.
• Case illustration of a patient developing FSGS and interstitial nephritis after VEGFR inhibitor treatment.

Main Results:

• Thrombotic microangiopathy is the most commonly reported kidney injury pattern.
• Other patterns include focal segmental glomerulosclerosis (FSGS) and interstitial nephritis, as exemplified by a patient case.
• Cessation of therapy and corticosteroids can lead to partial remission.

Conclusions:

• Anti-VEGF therapies can induce diverse renal pathologies beyond thrombotic microangiopathy.
• Awareness of these potential kidney injuries is essential for oncologists and nephrologists.
• Prompt diagnosis and management can improve patient outcomes and preserve renal function.