Division of Nephrology, University of Alabama at Birmingham, Birmingham, AL, USA.
Am J Kidney Dis. 2013 Jun;61(6):1026-31. doi: 10.1053/j.ajkd.2013.01.022. Epub 2013 Mar 27.
Since the introduction of imatinib, tyrosine kinase inhibition has been a mainstay in the treatment of many malignancies. The number of these medications is growing, as are the number of targeted tyrosine kinases. Off-target effects of these medications can have beneficial or adverse effects on the kidney. The onus of knowing the implications of these medications on kidney function, and appropriate treatment when such adverse effects occur, is on the nephrologist. We present a patient with chronic myelogenous leukemia who developed nephrotic-range proteinuria after initiation on dasatinib therapy that resolved after changing therapy to imatinib. The mechanism of kidney injury caused by dasatinib has not been described previously in the literature. We provide a review of vascular endothelial growth factor and its pharmacologic inhibition as it pertains to kidney pathology and propose possible mechanisms by which dasatinib induces kidney injury.
自伊马替尼问世以来，酪氨酸激酶抑制已成为许多恶性肿瘤治疗的主要手段。这些药物的数量在不断增加，靶向酪氨酸激酶的数量也在不断增加。这些药物的脱靶效应可能对肾脏产生有益或不利的影响。了解这些药物对肾功能的影响以及发生不良反应时的适当治疗方法的责任在于肾病学家。我们介绍了一位慢性髓性白血病患者，他在开始接受达沙替尼治疗后出现肾病范围的蛋白尿，在改为伊马替尼治疗后蛋白尿得到缓解。达沙替尼引起肾损伤的机制以前在文献中没有描述过。我们回顾了血管内皮生长因子及其在肾脏病理方面的药理抑制，并提出了达沙替尼诱导肾损伤的可能机制。
