Related Experiment Video
Updated: Aug 24, 2025
Chemotherapy-induced Vascular Toxicity - Real-time In vivo Imaging of Vessel Impairment
Published on: January 7, 2015
[Clinical and laboratory signs and risk factors for nephrotoxicity, associated with antiangiogenic drugs]
K S Grechukhina1,2, N V Chebotareva3, L G Zhukova2
1Lomonosov Moscow State University.
Background:
Anti-angiogenic anticancer drugs that block the vascular endothelial growth factor signaling pathway can cause renal damage. Assessment of the risk of nephrotoxicity allows developing optimal treatment approaches and ensuring the relative safety of therapy.
Aim:
To assess early clinical and laboratory manifestations and risk factors for nephrotoxicity of antiangiogenic drugs.
Materials And Methods:
The study included 50 patients who received antiangiogenic drugs in different regimens of chemotherapy. Demographic factors, body mass index, blood pressure levels, type of antiangiogenic drug, and concomitant therapy were assessed. Before treatment and over a period of 8 weeks, the levels of hemoglobin, number of platelets and schistocytes, D-dimer levels, serum lactate dehydrogenase (LDH) levels, as well as daily proteinuria and serum creatinine and eGFRCKD-EPI were assessed. Linear regression analysis was performed to assess risk factors for nephrotoxicity and arterial hypertension (AH).
Results:
The median age of patients was 46 [3457] years, 22 (44%) men and 28 (56%) women. AH developed in 52%, a decrease in eGFR in 42%, along with a decrease in hemoglobin levels and an increase in LDH levels at 2 weeks of therapy. The numbers of schistocytes and platelets significantly decreased by 8 weeks of therapy. Risk factors for impaired renal function during treatment with antiangiogenic drugs were an initial decrease in GFR less than 80 ml/min/1.73 m2, an increase in D-dimer levels, and a decrease in hemoglobin levels by 8 weeks of treatment. The risk factors for AH during therapy were the initial decrease in eGFR less than 80 ml/min/1.73 m2 and no prophylactic anticoagulant therapy.
Conclusion:
Early signs of nephrotoxicity of antiangiogenic anticancer drugs were a decrease in eGFR and AH. The independent risk factors for nephrotoxicity were the initial decrease in eGFR, an increase in D-dimer levels, and a decrease in hemoglobin levels at 8 weeks of treatment, while the prophylactic use of anticoagulant therapy reduced this risk in our study.
Insights
Anti-angiogenic drugs can harm kidneys. Early signs include decreased eGFR and high blood pressure. Initial low eGFR, high D-dimer, and low hemoglobin are risk factors for kidney damage.
Area of Science:
- Oncology
- Nephrology
- Pharmacology
Context:
- Anti-angiogenic therapies targeting VEGF pathway are crucial in cancer treatment.
- These drugs can induce significant renal damage, necessitating careful monitoring.
- Understanding nephrotoxicity risk is key for optimizing patient care and safety.
Purpose:
- To identify early clinical and laboratory indicators of nephrotoxicity.
- To determine risk factors associated with anti-angiogenic drug-induced kidney injury.
- To assess the incidence of hypertension and renal function decline.
Summary:
- This study analyzed 50 patients undergoing anti-angiogenic chemotherapy.
- Early manifestations included decreased estimated glomerular filtration rate (eGFR) and arterial hypertension (AH) within 2 weeks.
- Key risk factors identified were baseline eGFR < 80 ml/min/1.73 m2, elevated D-dimer, and decreased hemoglobin at 8 weeks.
Impact:
- Identifies early warning signs for nephrotoxicity, enabling timely intervention.
- Provides critical data on risk factors for renal impairment and AH in patients on anti-angiogenic drugs.
- Suggests prophylactic anticoagulant therapy may mitigate risks, improving treatment safety profiles.
More Related Videos
07:38Induction of Nephrotic Syndrome in Mice by Retrobulbar Injection of Doxorubicin and Prevention of Volume Retention by Sustained Release Aprotinin
Published on: May 6, 2018
06:38Early Detection of Drug-Induced Renal Hemodynamic Dysfunction Using Sonographic Technology in Rats
Published on: March 11, 2016
Related Concept Videos
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
01:24Chronic Kidney Disease II: Clinical Manifestations
01:29Acute Kidney Injury III: Clinical Manifestations
01:24Nephrotic Syndrome I : Introduction
01:16Kidney Transplant III: Nursing Management
01:18Chronic Kidney Disease IV: Nursing Management