Renal complications associated with targeted cancer therapy: Evaluation and management

Targeted cancer therapies have revolutionized oncology, offering improved survival for many malignancies. However, these treatments are associated with significant renal complications, including acute kidney injury (AKI), chronic kidney disease (CKD), proteinuria, hypertension, and thrombotic microangiopathy (TMA). This review summarizes the nephrotoxic effects of various targeted agents, such as vascular endothelial growth factor VEGF inhibitors, tyrosine kinase inhibitors (TKIs), cyclin-dependent kinase 4/6 (CDK4/6) inhibitors, and poly (ADP-ribose) polymerase (PARP) inhibitors, while providing evidence-based management strategies. Special emphasis is placed on distinguishing true AKI from “pseudo-AKI” caused by tubular creatinine secretion inhibition. A multidisciplinary approach, including renal function monitoring, drug dose adjustments, and antihypertensive management, highlight the importance of multidisciplinary collaboration between nephrologists and oncologists as well as shows how crucial it is for optimizing outcomes in cancer patients with kidney disease.