Which one of these is the most common renal manifestation of the drug "sunitinib"( Tyrosine kinase inhibitor)?
Most of you got it right. Dr.Tamim Naber actually gave out the answer in the last post on Onco Nephrology. The Tyrosine Kinase inhibitors have been lately the life saving drugs in kidney cancer. The outcomes with these agents are really good. Since they act downstream of VEGF, there side effects will be similar to the side effects of Anti VEGF agents or " like pre eclampsia". Hence the most common pathology and clinical finding that we encounter is TMA. Cases of Nephrotic syndrome without biopsy have been described. AIN has also been shown by biopsy proven cases. Initially, you see HTN, with some non nephrotic proteinuria, slightly low platelets, elevated LDH, lower than usual haptoglobin and slight increase in Crt. Its not a full blown TTP or HUS but rather a spectrum of TMA as the constellation of findings.