Early Detection of Renal Toxicities Associated with Anticancer Drugs: The Role Nephrotoxicity in Cancer Patients

The introduction of immunotherapy (ICI), tyrosine kinase inhibitors (TKI) and anti-VEGF agents has improved the prognosis for cancer patients, but at the cost of insidious renal toxicity. The aim of this study is to demonstrate the benefits of screening for nephrotoxicity and to establish a structured approach to monitoring renal function. We conducted a prospective descriptive study involving 54 cancer patients treated with immunotherapy (41 per cent), anti-angiogenic agents (31 per cent) or TKIs (28 per cent), who were followed up for 4 months (January-April 2025) at the HMPIT. The mean age was 55.8 years. Clinically, incident hypertension was observed in 18 per cent of normotensive patients, and a worsening of blood pressure was noted in 4 out of 15 (27 per cent) patients with known hypertension. Proteinuria, initially absent in all patients, was detected in 18 per cent of patients (grade 1: 13 per cent; grade 2: 5 per cent). Abnormalities in urinary sediment were found in 15 per cent of cases. According to the KDIGO classification, acute kidney injury (AKI) was diagnosed in 6 per cent of patients (stage 1: 4 per cent; stage 2: 2 per cent). A decline in GFR to below 90 mL/min/1.73 m² was observed in 26 per cent of patients, of whom 3 per cent had a GFR between 30 and 44 mL/min/1.73 m².