Drug | Clinical renal syndrome | Renal histopathology | Prevention* |
Cytotoxic drugs |
Cyclophosphamide | - Hyponatremia (SIADH)
- Hemorrhagic cystitis
| | |
Gemcitabine | - AKI
- Hematuria
- Hypertension
- Proteinuria
| - Thrombotic microangiopathy
| |
Ifosfamide | - AKI
- NDI
- Proximal tubulopathy (Fanconi syndrome)
| | - Dose adjustment
- Intravenous fluids
|
Methotrexate | | - Acute tubular injury
- Crystalline nephropathy
| - Intravenous fluids
- Urinary alkalinization
|
Mitomycin C | - AKI
- Hematuria
- Hypertension
- Proteinuria
| - Thrombotic microangiopathy
| |
Nitrosoureas | | - Chronic interstitial nephritis
| |
Pemetrexed | - AKI
- NDI
- Proximal tubulopathy (Fanconi syndrome)
| - Acute tubular injury
- Interstitial fibrosis
| |
Platinum agents (cisplatin, carboplatin, oxaliplatin) | - AKI
- Hypomagnesemia
- NDI
- Proximal tubulopathy (Fanconi syndrome)
- Salt wasting
| | - Dose adjustment
- Intravenous fluids
- Intravenous magnesium
|
Vinca alkaloids | | | |
Targeted agents |
ALK inhibitors (crizotinib) | - AKI
- Electrolyte disorders
- Renal microcysts
| - Acute interstitial nephritis
- Acute tubular injury
| |
Anti-VEGF agents (aflibercept, bevacizumab) | - AKI
- Hypertension
- Proteinuria
| - Thrombotic microangiopathy
| |
BRAF inhibitors (dabrafenib, vemurafenib) | - AKI
- Electrolyte disorders
| - Acute interstitial nephritis
- Acute tubular injury
| |
EGFR inhibitors (cetuximab, erlotinib, gefitinib, panitumumab) | | | |
Imatinib | - AKI
- Chronic kidney disease
| | |
Rituximab | - AKI (tumor lysis syndrome)
| - Acute tubular injury
- Crystalline (uric acid) nephropathy
| - Hypouricemic agents (allopurinol, rasburicase)
- Intravenous fluids
|
Tyrosine kinase inhibitors (axitinib, pazopanib, sorafenib, regorafenib, sunitinib) | - AKI
- Hypertension
- Proteinuria
| - Acute interstitial nephritis
- Acute tubular injury
- Focal segmental glomerulosclerosis
- Thrombotic microangiopathy
| |
Immunotherapy agents |
Chimeric antigen receptor (CAR) T cells | - Capillary leak syndrome with AKI
- Electrolyte disorders
| | - Glucocorticoid prophylaxis
- Chemotherapy to reduce tumor burden
|
CTLA-4 inhibitors (ipilimumab, tremelimumab) | | - Acute interstitial nephritis
- Lupus-like glomerulonephritis
- Minimal change disease
| |
Interferons (alpha, beta, gamma) | - AKI
- Nephrotic-range proteinuria
| - Focal segmental glomerulosclerosis
- Thrombotic microangiopathy
| |
Interleukin-2 | - AKI
- Capillary leak syndrome
| | |
PD-1 inhibitors (nivolumab, pembrolizumab, cemiplimab) | | - Acute interstitial nephritis
- Acute tubular injury
- IgA nephropathy
- Minimal change disease
- Focal segmental glomerulosclerosis
- C3 glomerulopathy
- Membranous glomerulonephritis
| |
PD-L1 inhibitors (atezolizumab, durvalumab, avelumab) | | - Acute interstitial nephritis
| |
Other drugs |
Deferasirox | | - Acute interstitial nephritis
- Acute tubular injury
- Fanconi syndrome
| |
Pamidronate | | - Acute tubular injury
- Focal segmental glomerulosclerosis
| - Dose adjustment
- Increase infusion time
|
Sirolimus | | - Focal segmental glomerulosclerosis
| |
Zoledronate | | - Acute tubular injury
- Focal segmental glomerulosclerosis (rare)
| |