Korean J Intern Med.  2014 Jan;29(1):40-48. 10.3904/kjim.2014.29.1.40.

Renal adverse effects of sunitinib and its clinical significance: a single-center experience in Korea

• Baek SH
• Kim H
• Lee J
• Kim DK
• Oh KH
• Kim YS
• Han JS
• Kim TM
• Lee SH
• Joo KW

• KMID: 1792011
• DOI: http://doi.org/10.3904/kjim.2014.29.1.40

Abstract

BACKGROUND/AIMS
Sunitinib is an oral multitargeted tyrosine kinase inhibitor used mainly for the treatment of metastatic renal cell carcinoma. The renal adverse effects (RAEs) of sunitinib have not been investigated. The aim of this study was to determine the incidence and risk factors of RAEs (proteinuria [PU] and renal insufficiency [RI]) and to investigate the relationship between PU and antitumor efficacy.
METHODS
We performed a retrospective review of medical records of patients who had received sunitinib for more than 3 months.
RESULTS
One hundred and fifty-five patients (mean age, 58.7 +/- 12.6 years) were enrolled, and the mean baseline creatinine level was 1.24 mg/dL. PU developed in 15 of 111 patients, and preexisting PU was aggravated in six of 111 patients. Only one patient developed typical nephrotic syndrome. Following discontinuation of sunitinib, PU was improved in 12 of 17 patients but persisted in five of 17 patients. RI occurred in 12 of 155 patients, and the maximum creatinine level was 3.31 mg/dL. RI improved in two of 12 patients but persisted in 10 of 12 patients. Risk factors for PU were hypertension, dyslipidemia, and chronic kidney disease. Older age was a risk factor for RI. The median progression-free survival was significantly better for patients who showed PU.
CONCLUSIONS
The incidence of RAEs associated with sunitinib was lower than those of previous reports. The severity of RAEs was mild to moderate, and partially reversible after cessation of sunitinib. We suggest that blood pressure, urinalysis, and renal function in patients receiving sunitinib should be monitored closely.

Keyword

Acute kidney injury; Proteinuria; Sunitinib

MeSH Terms

Aged
Antineoplastic Agents/*adverse effects
Carcinoma, Renal Cell/complications/drug therapy/mortality
Female
Humans
Incidence
Indoles/*adverse effects
Kidney Neoplasms/complications/drug therapy/mortality
Male
Middle Aged
Proteinuria/*chemically induced/epidemiology
Pyrroles/*adverse effects
Renal Insufficiency/*chemically induced/epidemiology
Republic of Korea/epidemiology
Retrospective Studies
Risk Factors
Treatment Outcome
Antineoplastic Agents
Indoles
Pyrroles