Nguyen Matthew D, Fekrat Ryan, Gee Caroline, Demirci Arif Nihat, Kharabaf Sohrab, Le Dao, Tadros Mina, Nguyen Vu Q, Patel Samir, Truong Tai, Ahdoot Rebecca, Kurtz Ira B, Kerr Michael, Massoud Abanoub, Hanna Ramy
University of California Irvine, School of Medicine.
University of California Irvine, Department of Medicine.
Clin Kidney J. 2025 Jun 27;18(8):sfaf206. doi: 10.1093/ckj/sfaf206. eCollection 2025 Aug.
Intravitreal vascular endothelial growth factor inhibitors (IVEGFi) are used in the treatment of diabetic retinopathy, age-related macular degeneration (AMD) and central retinal vein obstruction. As we have previously reported, there are an increasing number of cases documenting IVEGFi with renal injury and increased concentrations in the serum. To assess this claim, we have developed a novel reporting system through an electronic registry for cases of suspected VEGFi injury.
A website with multiple data protection sets was created to educate, promote awareness and capture patient cases of suspected IVEGFi toxicity. The website displays the molecular biology of VEGF signaling, the process of absorption into the bloodstream, and study reports showing risks on case, cohort and epidemiologic levels. A Health Insurance Portability and Accountability Act (HIPAA)-compliant patient intake form was designed to collect renal, cardiovascular, cerebrovascular, renal biopsy and function data along with drug type, indication and frequency of administration.
In our updated cohort we added 16 total cases from the literature showing signs of renal injury from the patient population receiving VEGFi. In current literature, 46 cases of VEGFi-related renal injury have been documented. To them, we add our 16 cases for a total of 62 cases.
The current database for VEGFi-related nephrotoxicity constitutes the largest case series presented for this condition. This study opens the door for future studies to evaluate what subgroups experience acute kidney injury, proteinuria and hypertension exacerbations. Additionally, we may expand on our database to include timeline markers for symptomatic-correlative VEGFi usage and, in time, predictive measures on a larger scale to correlate comorbidity/drug use with drug effect and mechanism of action.
玻璃体内血管内皮生长因子抑制剂（IVEGFi）用于治疗糖尿病性视网膜病变、年龄相关性黄斑变性（AMD）和视网膜中央静脉阻塞。正如我们之前所报道的，越来越多的病例记录了IVEGFi导致肾损伤以及血清中浓度升高的情况。为了评估这一说法，我们通过一个电子登记系统开发了一种新颖的报告系统，用于记录疑似VEGFi损伤的病例。
创建了一个具有多个数据保护集的网站，用于教育、提高认识并收集疑似IVEGFi毒性的患者病例。该网站展示了VEGF信号传导的分子生物学、吸收进入血液循环的过程，以及显示病例、队列和流行病学水平风险的研究报告。设计了一份符合《健康保险流通与责任法案》（HIPAA）的患者 intake 表格，以收集肾脏、心血管、脑血管、肾活检和功能数据，以及药物类型、适应症和给药频率。
在我们更新的队列中，我们从文献中增加了16例来自接受VEGFi治疗的患者群体且显示出肾损伤迹象的病例。在当前文献中，已记录了46例VEGFi相关肾损伤病例。在此基础上，我们增加了16例，总计62例。
目前关于VEGFi相关肾毒性的数据库构成了针对这种情况所呈现的最大病例系列。这项研究为未来评估哪些亚组会经历急性肾损伤、蛋白尿和高血压加重的研究打开了大门。此外，我们可以扩展数据库，纳入与症状相关的VEGFi使用的时间线标记，并及时进行更大规模的预测措施，以将合并症/药物使用与药物效果和作用机制相关联。
