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Editorial
. 2023 Jan 16;16(4):603-610.
doi: 10.1093/ckj/sfad011. eCollection 2023 Apr.

Pseudo-AKI associated with targeted anti-cancer agents-the truth is in the eye of the filtration marker

Thomas Vanhoutte  1 , Ben Sprangers  2   3
Affiliations
Editorial

Pseudo-AKI associated with targeted anti-cancer agents-the truth is in the eye of the filtration marker

Thomas Vanhoutte et al. Clin Kidney J. .

Abstract

Besides true acute kidney injury (AKI), the occurrence of pseudo-AKI has been associated with several targeted agents. To improve the management of cancer patients treated with targeted agents, we need to be aware of this and use diagnostic approaches to differentiate between pseudo-AKI and AKI. In an article by Wijtvliet et al. in this issue of CKJ, tepotinib is added to the list of targeted agents associated with pseudo-AKI. In this editorial we discuss the current literature regarding pseudo-AKI and true AKI associated with targeted agents, and subsequently propose a management strategy to monitor kidney function in patients treated with targeted agents.

Keywords: acute kidney injury; creatinine; cystatin C; kidney function; targeted therapies.

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Conflict of interest statement

B.S. is member of the CKJ Editorial Board.

Figures

Figure 1:
Figure 1:
Proposed algorithm for elevated SCr levels in patients treated with targeted agents with known or anticipated potential for pseudo-AKI. UTO: urinary tract obstruction. 1New markers of kidney injury: new active sediment or significant proteinuria (>0.5 g/g creatinine) not explained by urinary tract infection. Stable markers of kidney injury: in patients with pre-existent CKD with known active sediment and/or proteinuria (e.g. immunoglobulin A nephropathy). 2In theory both SCr levels and CysC levels can be spuriously elevated because of concomitant targeted agent associated pseudo-AKI and CysC non-GFR-determinants (e.g. paraneoplastic, smoking, steroids, etc.). In this scenario measured GFR is conclusive.
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Comment in

References

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