ArticleSAGE open medical case reports2020
Intravitreal bevacizumab-induced exacerbation of proteinuria in diabetic nephropathy, and amelioration by switching to ranibizumab.
Article in SAGE open medical case reports, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed, 31 citations in OpenAlex.
- Evidence-Based Guidelines for Intravitreal Anti-VEGF Therapy for Diabetic Retinopathy in Chronic Kidney Disease.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2025Article
- Intravitreal vascular endothelial growth factor inhibitor systemic and renal toxicity registry.Clinical kidney journal · 2025Article
- Exploring the Molecular Modalities in the Pathogenesis of Diabetic Kidney Disease with a Focus on the Potential Therapeutic Implications.Biomedicines · 2024Review
- Ocular and systemic vascular endothelial growth factor ligand inhibitor use and nephrotoxicity: an update.International urology and nephrology · 2024Review
- Machine learning application identifies plasma markers for proteinuria in metastatic colorectal cancer patients treated with Bevacizumab.Cancer chemotherapy and pharmacology · 2024Article
- Divergent cardiac and renal effects of miR-181c-5p inhibition in a rodent heart failure model.Frontiers in cardiovascular medicine · 2024Article
- The Association of Intravitreal Anti-VEGF Injections With Kidney Function in Diabetic Retinopathy.Ophthalmology science · 2023Article
- Risk of renal damage associated with intravitreal anti-VEGF therapy for diabetic macular edema in routine clinical practice.Indian journal of ophthalmology · 2023Article
- Tumours modulate the systemic vascular response to anti-angiogenic therapy.Journal of applied toxicology : JAT · 2022Article
- miR-125a-5p attenuates macrophage-mediated vascular dysfunction by targeting Ninjurin1.Cell death and differentiation · 2022Article
- Improvement of the anticancer efficacy of PD-1/PD-L1 blockade via combination therapy and PD-L1 regulation.Journal of hematology & oncology · 2022Review
- Comprehensive Curative Effect of Targeting PD-1 or Traditional Single-Agent Chemotherapy in Second-Line Therapy for Terminal or Metastatic Esophageal Cancer: A Systematic Review and Meta-Analysis.Journal of oncology · 2022Review
- Review of intravitreal VEGF inhibitor toxicity and report of collapsing FSGS with TMA in a patient with age-related macular degeneration.Clinical kidney journal · 2021Article
- Hypertension in neonates treated with intravitreal bevacizumab for retinopathy of prematurity.Journal of perinatology : official journal of the California Perinatal Association · 2021Article
- Antiangiogenic therapy in diabetic nephropathy: A double‑edged sword (Review).Molecular medicine reports · 2021Review
- Worsening proteinuria and renal function after intravitreal vascular endothelial growth factor blockade for diabetic proliferative retinopathy.Clinical kidney journal · 2020Review
- High Density Display of an Anti-Angiogenic Peptide on Micelle Surfaces Enhances Their Inhibition of αvβ3 Integrin-Mediated Neovascularization In Vitro.Nanomaterials (Basel, Switzerland) · 2020Article
- Thrombotic Microangiopathy and Acute Kidney Injury Induced After Intravitreal Injection of Vascular Endothelial Growth Factor Inhibitors VEGF Blockade-Related TMA After Intravitreal Use.Frontiers in medicine · 2020Article
- Role of VEGF-A and LRG1 in Abnormal Angiogenesis Associated With Diabetic Nephropathy.Frontiers in physiology · 2020Review
- Refractory scleroderma renal crisis precipitated after high-dose oral corticosteroids and concurrent intravitreal injection of bevacizumab.SAGE open medical case reports · 2020Article
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
Certain diabetic and hypertensive patients started on intravitreal vascular endothelial growth factor inhibition for diabetic retinopathy may experience worsening of hypertension and proteinuria. The etiology of this is the newly recognized absorption of intravitreally injected vascular endothelial growth factor inhibitors, and the susceptibility of patients with pre-existing renal disease to exacerbations depends on the degree of systemic absorption. There are eighteen reported cases of worsening hypertension, woresening proteinuria, worsening renal function, thrombotic microangiopathy, and glomerular disease noted after initiation of intravitreal vascular endothelial growth factor blockade. This nineteenth case demonstrates worsening hypertension and proteinuria with the start of bevacizumab. Both blood pressure and proteinuria parameters showed overall improvement with switching to the less absorbed and lower potency agent ranibizumab. There was a slight rise in serum creatinine after bevacizumab therapy, which stabilized at a new baseline, and the serum creatinine remained stable on ranibizumab. There were no other nephrotoxic exposures that explained the mild rise in serum creatinine. Because of improvement in renal function and proteinuria, a renal biopsy was deferred for the time. This case re-demonstrates the risk of worsening proteinuria with vascular endothelial growth factor inhibitors when given intravitreally in some patients. The demonstration of improvement in blood pressure and proteinuria with the use of lower potency agents like ranibizumab is novel and an important concept confirming observations from pharmacokinetic studies. The switch to ranibizumab offers a therapeutic option when proteinuria worsens with intravitreal vascular endothelial growth factor blockade, and the patient requires ongoing intravitreal therapy for treatment of diabetic retinopathy.
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