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Updated: Jun 8, 2025
Assessment of Kidney Function in Mouse Models of Glomerular Disease
Published on: June 30, 2018
The impact of VEGF signalling pathway inhibitors and/or immune checkpoint inhibitors on kidney function over time: a
Benjamin M P Elyan1,2, Michael K Sullivan3,4, James Hedley5
1School of Cardiovascular and Metabolic Health, College of Medical and Veterinary Life Sciences, University of Glasgow, Glasgow, UK. Benjamin.Elyan@glasgow.ac.uk.
Background:
Drugs targeting angiogenesis and immunotherapy have transformed outcomes in renal cancer but may contribute to progressive kidney disease.
Methods:
We linked healthcare databases in the West of Scotland (spanning 2010-2020) to identify adults with renal cancer who received one or both classes of drugs. Over two years following initiation, estimated glomerular filtration rate (eGFR) slope was modelled using linear mixed-effects models. Additional renal outcomes used competing risk regression considering the competing risk of death.
Results:
Amongst 357 adults (62.5% male; median age 63.0 years, IQI 55.0-71.0), there was no significant change in eGFR (annual eGFR change +1.03 mL/min/1.73 m²/year, 95%CI -1.64 to +3.70), nor in subgroups of patients who had nephrectomy, metastatic cancer or an eGFR < 60 mL/min/1.73 m² prior to systemic therapy. A ≥ 40% decline in eGFR occurred in 82 people (23.0%) within one year of starting systemic therapy and was associated with pre-existing diabetes (subhazard ratio 1.89, 95%CI 1.05-3.41).
Discussion:
Anti-angiogenic and immune therapy had no substantial impact on the average change in eGFR but people with diabetes are at higher risk of clinically significant renal events. With appropriate monitoring, more widespread use of these agents in patients with renal impairment may be warranted.
Insights
New renal cancer drugs show no significant average impact on kidney function, but patients with diabetes face higher risks of kidney events. Careful monitoring allows wider use in impaired kidneys.
Area of Science:
- Nephrology
- Oncology
- Pharmacology
Background:
- Anti-angiogenic and immunotherapy drugs have improved renal cancer outcomes.
- These treatments may also lead to progressive kidney disease.
Purpose of the Study:
- To evaluate the impact of anti-angiogenic and immunotherapy drugs on kidney function in renal cancer patients.
- To identify risk factors for significant renal events in this population.
Main Methods:
- Retrospective analysis of healthcare databases (2010-2020) in West Scotland.
- Inclusion of adult renal cancer patients receiving anti-angiogenic or immunotherapy.
- Modeling of estimated glomerular filtration rate (eGFR) slope and renal outcomes using statistical methods.
Main Results:
- No significant average change in eGFR observed in 357 patients.
- Subgroup analyses (nephrectomy, metastatic cancer, pre-existing renal impairment) showed no significant eGFR change.
- A 40% decline in eGFR within one year occurred in 23% of patients, associated with pre-existing diabetes.
Conclusions:
- Anti-angiogenic and immune therapies have a limited impact on average eGFR in renal cancer patients.
- Patients with diabetes are at increased risk for substantial renal events.
- With monitoring, these therapies may be safely used in patients with renal impairment.
