Thrombotic microangiopathy associated with proteasome inhibitors

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Cell Subtype-specific Analysis of Neuronal Membrane Proteasome in Somatosensory Neurons
09:27

Cell Subtype-specific Analysis of Neuronal Membrane Proteasome in Somatosensory Neurons

Published on: October 10, 2025

719

Ahad Lodhi1, Abhishek Kumar1, Muhammad U Saqlain1

  • 1Department of Nephrology, Internal Medicine , University of Iowa Hospitals and Clinics , Iowa City, IA 52246 , USA.

Clinical Kidney Journal
|September 29, 2015
PubMed

Insights

Proteasome inhibitors Bortezomib (BTZ) and Carfilzomib (CFZ) treat multiple myeloma but can cause acute kidney injury (AKI). This review explores the pathogenesis of this AKI, including a case of CFZ-induced thrombotic microangiopathy.

Area of Science:

  • Nephrology
  • Oncology
  • Molecular Biology

Background:

  • The ubiquitin proteasome pathway is crucial for cellular processes.
  • Proteasome inhibitors like Bortezomib (BTZ) and Carfilzomib (CFZ) are used for multiple myeloma.
  • Acute kidney injury (AKI) has been reported with these inhibitors, but mechanisms are unclear.

Purpose of the Study:

  • To discuss the association and pathogenesis of proteasome inhibitor-associated AKI.
  • To report a novel case of Carfilzomib-associated AKI with specific kidney biopsy findings.

Main Methods:

  • Literature review on proteasome inhibitors and AKI.
  • Case report detailing clinical presentation, kidney biopsy, and laboratory findings.

Main Results:

  • Proteasome inhibitors are linked to AKI, with various proposed mechanisms.
  • The reported case showed Carfilzomib-associated AKI with thrombotic microangiopathy and microangiopathic hemolytic anemia on biopsy.

Conclusions:

  • Proteasome inhibitors can induce AKI through diverse mechanisms.
  • Thrombotic microangiopathy is a potential cause of AKI in patients treated with Carfilzomib.
Keywords:
onconephrology

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