医学
血管抑制剂
血管内皮生长因子
血栓性微血管病
贝伐单抗
阿柏西普
肾毒性
肾脏疾病
肾功能
血管生成
药理学
蛋白尿
重症监护医学
内科学
生物信息学
肾
疾病
血管内皮生长因子受体
化疗
生物
作者
Ramy M Hanna,Marina Barsoum,Farid Arman,Umut Selamet,Huma Hasnain,Ira Kurtz
标识
DOI:10.1016/j.kint.2019.02.042
摘要
Vascular endothelial growth factor (VEGF) inhibitors have emerged as powerful tools to treat malignant neoplasms and ocular diseases by virtue of their ability to inhibit angiogenesis. Recent data indicate that intravitreal injections of VEGF inhibitors can lead to significant systemic absorption as well as a measurable reduction of plasma VEGF activity. There is increasing evidence showing that vitreal absorption of these drugs is associated with cases of accelerated hypertension, worsening proteinuria, glomerular disease, thrombotic microangiopathy, and possible chronic renal function decline. In this review, the 3 most commonly used anti-VEGF agents-bevacizumab, ranibizumab, and aflibercept-are discussed, highlighting their intravitreal absorption and associated effects on the kidney as a target organ system. We provide clinical suggestions for clinicians to both better manage patients receiving anti-VEGF agents intravitreally and detect any putative systemic renal effects of these agents. While acknowledging the risks of aberrant retinal angiogenesis, it is important for clinicians to be aware of the potential for adverse renal risks with use of these agents.
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