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Nintedanib-induced glomerular microangiopathy: a case report

Masataka Hasegawa1, Atsuko Uehara2, Tomo Suzuki1,3

  • 1Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1, Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan.

CEN Case Reports
|April 13, 2020
PubMed

Insights

Nintedanib, a tyrosine kinase inhibitor, may cause glomerular microangiopathy, a rare kidney injury. Monitoring kidney function is recommended for patients on this medication.

Area of Science:

  • Nephrology
  • Oncology
  • Pharmacology

Background:

  • Nintedanib is a triple tyrosine kinase inhibitor used for idiopathic pulmonary fibrosis and advanced non-small cell lung cancer.
  • Vascular endothelial growth factor inhibitors are known to cause endothelial injury and glomerular microangiopathy.

Observation:

  • A 68-year-old male patient developed proteinuria and leg edema after initiating nintedanib.
  • Kidney biopsy showed significant endothelial and mesangial injury.

Findings:

  • This case represents the second report of nintedanib-induced glomerular microangiopathy.
  • Proteinuria resolved upon discontinuation of nintedanib, suggesting a causal link.

Implications:

  • Nintedanib may induce glomerular microangiopathy, necessitating vigilance in patients undergoing treatment.
  • Monitoring urinary protein excretion and blood pressure is crucial for early detection of nintedanib-induced nephropathy.
  • Kidney biopsy is essential for diagnosing nintedanib-induced glomerular microangiopathy and guiding management.
Keywords:
Glomerular microangiopathyNintedanibOnconephrologyProteinuriaPulmonary fibrosis

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