RT Journal Article SR Electronic T1 A case of ramucirumab-induced renal failure with nephrotic-range proteinuria and its pathological findings JF BMJ Case Reports JO BMJ Case Reports FD BMJ Publishing Group Ltd SP e239603 DO 10.1136/bcr-2020-239603 VO 14 IS 3 A1 Yuta Nakano A1 Jiro Kumagai A1 Kiyotaka Nagahama A1 Hajime Fujisawa YR 2021 UL http://casereports.bmj.com/content/14/3/e239603.abstract 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.