PT  - JOURNAL ARTICLE
AU  - Yuta Nakano
AU  - Jiro Kumagai
AU  - Kiyotaka Nagahama
AU  - Hajime Fujisawa
TI  - A case of ramucirumab-induced renal failure with nephrotic-range proteinuria and its pathological findings
AID  - 10.1136/bcr-2020-239603
DP  - 2021 Mar 01
TA  - BMJ Case Reports
PG  - e239603
VI  - 14
IP  - 3
4099  - http://casereports.bmj.com/content/14/3/e239603.short
4100  - http://casereports.bmj.com/content/14/3/e239603.full
SO  - BMJ Case Reports2021 Mar 01; 14
AB  - Ramucirumab-induced renal dysfunction is rarely reported. The pathology of ramucirumab-associated nephropathy in past reports primarily shows thrombotic microangiopathy (TMA) lesions but podocytopathy is not yet known. We report a case of kidney injury induced by ramucirumab in a 71-year-old man with cecal cancer. He was referred to our department for increasing serum creatinine (Cr) levels from 1.08 mg/dL to 2.56 mg/dL after changing anticancer drugs from bevacizumab to ramucirumab. He showed nephrotic-range proteinuria (12.1 g/gCr). A renal biopsy revealed endothelial cell injuries, such as TMA and podocytopathy with epithelial cell hyperplasia, which looked like a crescent. After discontinuing ramucirumab, his renal function and proteinuria improved, as seen by his Cr levels and proteinuria which decreased to 1.74 mg/dL and 1.21 g/gCr, respectively, in 3 months. Unlike previous reports, we found that ramucirumab caused podocyte injuries.