Related Experiment Video

Updated: Nov 15, 2025

Analyses of Proteinuria, Renal Infiltration of Leukocytes, and Renal Deposition of Proteins in Lupus-prone MRL/lpr Mice
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Analyses of Proteinuria, Renal Infiltration of Leukocytes, and Renal Deposition of Proteins in Lupus-prone MRL/lpr Mice

Published on: June 8, 2022

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A case of ramucirumab-induced renal failure with nephrotic-range proteinuria and its pathological findings

Yuta Nakano1, Jiro Kumagai2, Kiyotaka Nagahama3

  • 1Nephrology, Yokohama City Minato Red Cross Hospital, Yokohama, Japan ynakano.kid@tmd.ac.jp.

BMJ Case Reports
|March 3, 2021
PubMed

Insights

Ramucirumab can cause kidney injury, including rare podocytopathy, not just thrombotic microangiopathy. Discontinuing the drug improved renal function and proteinuria in a patient with cecal cancer.

Area of Science:

  • Nephrology
  • Oncology
  • Pharmacology

Background:

  • Ramucirumab is an angiogenesis inhibitor used in cancer therapy.
  • Renal dysfunction is a rare adverse effect of ramucirumab.
  • Previous reports linked ramucirumab-induced nephropathy mainly to thrombotic microangiopathy (TMA).

Observation:

  • A 71-year-old man with cecal cancer developed worsening kidney injury after switching from bevacizumab to ramucirumab.
  • The patient presented with elevated creatinine and nephrotic-range proteinuria.
  • Renal biopsy revealed TMA and podocytopathy with crescent formation.

Findings:

  • This case demonstrates ramucirumab-induced podocytopathy, a finding not previously described.
  • The patient's renal function and proteinuria significantly improved after ramucirumab discontinuation.

Implications:

  • Ramucirumab may cause a broader spectrum of kidney injury than previously recognized, including podocyte damage.
  • Clinicians should consider ramucirumab-induced nephropathy in patients developing renal dysfunction during treatment.
  • Early recognition and drug withdrawal may lead to recovery of kidney function.
Keywords:
acute renal failureoncologypathologyproteinurea

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