VEGF signalling inhibition-induced proteinuria: Mechanisms, significance and management

摘要: Proteinuria is a dose-related side-effect occurring after inhibition of vascular endothelial growth factor (VEGF) signalling and may reflect severe glomerular damage. The the VEGF axis induces downexpression or suppression nephrin, an important protein for maintenance slit diaphragm, sometimes leading to nephritic syndrome and/or thrombotic microangiopathy, main-associated kidney disease. A MEDLINE search was carried out using following criteria: (1) all listings as 01-01-2000 with abstracts; (2) English language; (3) Humans. phrases were used query database: (proteinuria) AND (anti-VEGF OR bevacizumab sunitinib sorafenib Trap axitinib pazopanib AZ 2171). references each article identified carefully reviewed additional reference. incidence mild asymptomatic proteinuria ranges from 21% up 63%, but heavy has been reported in 6.5% renal cell carcinoma patients. Although discontinuation anti-VEGF agent induced significant reduction, persistence common. angiotensinconverting-enzyme inhibitors angiotensin receptor blockers seem be preferred, no specific recommendation antiproteinuric can made this context because there are controlled studies addressing subject. Periodic monitoring urinary should anti-VEGF-treated patients showing need special referral nephrologists.