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Dasatinib-induced nephrotic-range proteinuria

Eric Wallace1, William Lyndon, Phillip Chumley

  • 1Division of Nephrology, University of Alabama at Birmingham, Birmingham, AL, USA. ericlwallace@uab.edu

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
|April 2, 2013
PubMed

Insights

Tyrosine kinase inhibitors (TKIs) like dasatinib can cause kidney damage, including nephrotic-range proteinuria. Switching to imatinib resolved the patient's kidney injury, highlighting the need for nephrologists to monitor TKI side effects.

Area of Science:

  • Oncology
  • Nephrology
  • Pharmacology

Background:

  • Tyrosine kinase inhibitors (TKIs) are crucial in treating malignancies, targeting specific kinases.
  • The expanding use of TKIs necessitates understanding their potential off-target effects on kidney function.
  • Nephrologists must be aware of and manage TKI-induced kidney pathologies.

Observation:

  • A patient with chronic myelogenous leukemia developed nephrotic-range proteinuria after starting dasatinib.
  • The proteinuria resolved upon discontinuation of dasatinib and initiation of imatinib therapy.
  • This case highlights a previously undescribed mechanism of kidney injury associated with dasatinib.

Findings:

  • Dasatinib therapy was associated with the development of nephrotic-range proteinuria.
  • Switching to imatinib led to the resolution of proteinuria, suggesting a drug-specific effect.
  • The study reviews the role of vascular endothelial growth factor (VEGF) in kidney pathology related to TKI therapy.

Implications:

  • This case underscores the importance of vigilant renal monitoring in patients receiving TKIs.
  • Understanding the mechanisms of TKI-induced kidney injury is crucial for appropriate management.
  • Further research into the specific nephrotoxic pathways of drugs like dasatinib is warranted.

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