VEGF modulation and renal effects: Case report and review of the literature
Abstract
Angiogenesis has been known for decades to be an essential step in cancer growth. In recent years, the vascular endothelial growth factor (VEGF) family was identified as a crucial stimulus (and product by tumors) for neovascularization, nutrition, oxygen delivery, and metastatic dissemination; VEGF inhibition currently has an important role in cancer therapy. The development and increased use of VEGF inhibitors has led to the identification of side effects and renal complications. Vascular endothelial growth factor is produced by renal podocytes to maintain a healthy endothelium, mesangium, and tubular structures. With the disruption of nutritional processes in the kidney, there can be renal injury starting at the cellular level and referred to by some experts as anti-VEGF nephropathy (hypertension, thrombotic microangiopathy, proteinuria, renal failure).
Here we present the case of a man with renal cell carcinoma who was treated with surgical resection and later started on sunitinib. He developed several acute and chronic medical problems, including some related to anti-VEGF toxicity.
Keywords: Vascular endothelial growth factor, sunitinib, anti-VEGF nephropathy, renal cell carcinoma, podocytes, thrombotic microangiopathy, hypertension, acute renal injury
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