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KIDNEY INJURY DURING TREATMENT WITH AFLIBERCEPT VERSUS RANIBIZUMAB: A Population-Based Study

Robert J Campbell1,2,3, Sherif R El-Defrawy4,5, Sudeep S Gill1,6,7

  • 1ICES, Kingston and Toronto, Ontario, Canada.

Retina (Philadelphia, Pa.)
|September 9, 2025
PubMed
Abstract

Insights

Intravitreal aflibercept and ranibizumab, used for eye conditions, show similar risks for kidney injury in older adults. This finding is important for understanding the safety of these vascular endothelial growth factor inhibitors.

Area of Science:

  • Ophthalmology
  • Nephrology
  • Pharmacology

Background:

  • Systemic vascular endothelial growth factor (VEGF) inhibitors can cause kidney damage.
  • Intravitreal aflibercept affects systemic VEGF levels more than ranibizumab.
  • Understanding the renal safety profiles of these treatments is crucial.

Purpose of the Study:

  • To compare the risk of kidney injury in patients receiving intravitreal aflibercept versus ranibizumab.
  • To evaluate adverse renal outcomes associated with these anti-VEGF therapies.

Main Methods:

  • Population-based cohort study in Ontario, Canada.
  • Included 44,571 patients aged 66+ newly treated with aflibercept or ranibizumab (2015-2019).
  • Controlled for baseline and time-varying covariates to compare renal outcomes.

Main Results:

  • Composite renal outcome occurred in 12.0% of aflibercept recipients vs. 10.0% of ranibizumab recipients.
  • Relative risk was 1.00 (95% CI: 0.93-1.06) at 5-year follow-up.
  • No significant differences in renal risk were found across retinal disease subgroups.

Conclusions:

  • Intravitreal aflibercept and ranibizumab have comparable risks of renal adverse events.
  • This similarity exists despite differences in their systemic pharmacodynamics.
  • Both treatments appear to have similar renal safety profiles in the elderly population.
Keywords:
afliberceptkidney injuryranibizumabrenal adverse eventsrenal failureretinal diseaseretrospective cohort study

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