Fol. Biol. 2013, 59, 15-25
Proteinuria and Hypertension in Patients Treated with Inhibitors of the VEGF Signalling Pathway – Incidence, Mechanisms and Management
Anti-VEGF therapy dramatically improved the outcome of patients with renal cancer and other advanced malignancies, but may be complicated by proteinuria and hypertension. VEGF is indispensable for the normal development of glomerulus and preservation of glomerular filtration barrier. Interference with its action may result in damage to glomerular endothelial cells and (in severe cases) in renal thrombotic microangiopathy. Blood pressure and proteinuria (using dipstick) should be assessed in all patients before starting anti-VEGF therapy and regularly monitored during the treatment. Patients with severe proteinuria and/or impaired renal function should be referred to the nephrologist for further work-up. Hypertension caused by anti-VEGF therapy can be effectively treated; progression of proteinuria and/or renal dysfunction may require tapering, or even withdrawal of anti-VEGF treatment.
Keywords
VEGF inhibition, proteinuria, hypertension, bevacizumab, sunitinib, sorafenib.
Funding
The paper was prepared with the support of the research programmes of the First Faculty of Medicine, Charles University in Prague, PRVOUK P25 and P27.
References
Copyright
This is an open-access article distributed under the terms of the Creative Commons Attribution License.
