A recent retrospective study in Annals of Oncology takes on the use of the tyrosine kinase inhibitors sunitinib and sorafenib in the CKD patients and even patients on dialysis. Onco-Nephrology or the role of the nephrologists in the care of the cancer patients is becoming more and more important as most new chemo drugs are known to cause some degree of renal damage.
Tyrosine kinase inhibitors have anti VEGF effects and now have known to cause AKI, AIN, proteinuria, HTN and sometimes a pre eclampsia like syndrome as well.
Using them in CKD patients would scare me. This study , although retrospective showed that with dose modifications, even patients on dialysis and CKD received it with no renal toxicity. Perhaps dialysis removes some metabolite that might be reno toxic.
This is more and more important as nephrologist we might get scared of few cases in the literature causing injury but for that specific patient with cancer, these drugs might be those few months of quality of life and hope.
Having studies like these are important to stress that in the big scheme of things, these drugs still are good for treating Renal Cell Cancer and just because they have renal side effects, we should not avoid them. Rather, use them with caution and watch for changes in crt, HTN and proteinuria and monitor patients more closely.
Other key references:
- ► 2017 (42)
- ► 2016 (45)
- ► 2015 (63)
- ► 2014 (95)
- ► 2013 (133)
- ► 2012 (201)
- ► 2011 (370)
- JOURNAL CLUB: Metabolic Acidosis and improving GFR...
- The Online Transplant Center: Kidney Biopsy in Hea...
- Kidney Biopsy in Heart Transplant Candidates?
- TOPIC DISCUSSION: Cellular Senescence and Renal Ag...
- CLINICAL CASE 12
- CLINICAL CASE 11
- IN THE NEWS ---> Vancomycin and the kidney
- TOPIC DISCUSSION: Smoking and Kidney Disease
- The Online Transplant Center: Dual Liver and Kidne...
- The Online Transplant Center: HIV and the Kidney T...
- The Online Transplant Center: Obesity and Kidney T...
- Dual Liver and Kidney Transplantations
- HIV and the Kidney Transplant
- Obesity and Kidney Transplantation
- In the News: ASN website for Renal Fellows
- TOPIC DISCUSSION: Adolescents and Disease
- TOPIC DISCUSSION: Why do AVG and AVF get stenosis?...
- NKF reports
- CONSULT ROUNDS
- TOPIC DISCUSSION: Asymptomatic Hyponatremia
- IN THE NEWS- RENAL ANGINA SYNDROME
- CLINICAL CASE 10, ANSWER AND SUMMARY
- TOPIC DISCUSSION: PHOSPHATE BINDERS
- TOPIC DISCUSSION: A rare case of statin induced rh...
- IN THE NEWS: GLOSEN Study
- IN THE NEWS: Dialysis Time
- TOPIC DISCUSSION: Albuminuria and Proteinuria
- The Online Transplant Center: Antibody Mediated Re...
- Antibody Mediated Rejection Review
- The Online Transplant Center: Bone marrow transpla...
- Bone marrow transplantation and solid organs
- IN THE NEWS: Tyrosine Kinase Inhibitors and CKD
- IN THE NEWS- MORE NEPHROLOGY CONSULTS
- ▼ April (33)