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Updated: Dec 24, 2025
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Effects of sunitinib on endothelial dysfunction, metabolic changes, and cardiovascular risk indices in renal cell
Silvia Lai1, Maria Ida Amabile1, Sandro Mazzaferro2
1Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy.
Background:
Sunitinib is a standard treatment for metastatic renal cell carcinoma (RCC). Currently, the data available on the effects of sunitinib on endothelial dysfunction, metabolic changes, and cardiovascular (CV) risk factors are limited, and we aimed to evaluate these aspects in patients with RCC after a short period of treatment.
Methods:
Patients affected by metastatic RCC were enrolled and evaluated before starting sunitinib (T0) and after 40 days of treatment (T1) by the flow-mediated dilation (FMD), carotid intima media thickness (IMT), ankle-brachial pressure index (ABI), and 24-hour proteinuria. We also assessed serum metabolic and nutritional parameters at T0 and T1.
Results:
Twenty patients (7 female), with a mean age of 61.4 ± 12.0 years, were studied. Overtime, we observed a reduction in estimated glomerular filtration rate (P = .002), FMD (P = .001) and in fasting plasma glucose levels (P = .04), as well as an increase in plasma insulin (P < .001), HOMA-IR (P < .01), and serum total cholesterol levels (P = .01). Moreover at T1 we found a significant increase in systolic and diastolic blood pressure (P ≤ .001) and 24-hour proteinuria (P < .001) compared to baseline, whereas no changes in IMT and ABI were detected.
Conclusion:
The changes observed overtime after sunitinib treatment in terms of markers of early endothelial dysfunction, blood pressure, as well as in glucose/insulin metabolism and proteinuria may contribute to increase CV risk in RCC patients and suggest a strict follow-up in this setting. Larger evidences are mandatory to confirm our observations.
Insights
Sunitinib treatment for metastatic renal cell carcinoma (RCC) may increase cardiovascular risk by worsening endothelial dysfunction, blood pressure, and metabolic changes. Close patient monitoring is recommended due to these sunitinib side effects.
Area of Science:
- Cardiovascular Medicine
- Nephrology
- Pharmacology
Background:
- Sunitinib is a standard treatment for metastatic renal cell carcinoma (RCC).
- Limited data exist on sunitinib's effects on endothelial dysfunction, metabolic changes, and cardiovascular (CV) risk factors.
- This study evaluates these aspects in RCC patients undergoing short-term sunitinib treatment.
Purpose of the Study:
- To assess the impact of short-term sunitinib treatment on endothelial function.
- To evaluate changes in metabolic parameters and cardiovascular risk factors in metastatic RCC patients.
- To determine the early effects of sunitinib on CV health.
Main Methods:
- Twenty patients with metastatic RCC were evaluated before (T0) and after 40 days (T1) of sunitinib treatment.
- Flow-mediated dilation (FMD), carotid intima media thickness (IMT), ankle-brachial pressure index (ABI), and 24-hour proteinuria were measured.
- Serum metabolic parameters, including glucose and insulin levels, were assessed.
Main Results:
- Sunitinib treatment led to reduced estimated glomerular filtration rate, FMD, and fasting plasma glucose.
- Significant increases were observed in plasma insulin, HOMA-IR, total cholesterol, blood pressure, and 24-hour proteinuria.
- No significant changes were detected in IMT or ABI.
Conclusions:
- Short-term sunitinib treatment can induce early endothelial dysfunction, alter glucose/insulin metabolism, and increase proteinuria and blood pressure.
- These changes may contribute to increased cardiovascular risk in RCC patients.
- Strict patient follow-up is suggested, and further research is needed to confirm these findings.
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