ArticleFrontiers in medicine2020
Thrombotic Microangiopathy and Acute Kidney Injury Induced After Intravitreal Injection of Vascular Endothelial Growth Factor Inhibitors VEGF Blockade-Related TMA After Intravitreal Use.
Article in Frontiers in medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 45 citations in OpenAlex.
- Effect of intravitreal VEGF inhibitors on renal-related adverse events in patients with diabetes mellitus: systematic review and meta-analysis.Frontiers in pharmacology · 2025Pooled it
- Therapeutic monoclonal antibodies for diabetic kidney disease: a narrative review from basic mechanisms to clinical evidence.Frontiers in endocrinology · 2026Review
- Cardiovascular Safety of VIAN-c4551, an Antiangiogenic Peptide Derived From Vasoinhibin.Drug development research · 2025Article
- Systemic Effects of Intravitreal Anti-VEGF Therapy: A Review of Safety across Organ Systems.Ophthalmology and therapy · 2025Review
- Intravitreal vascular endothelial growth factor inhibitor systemic and renal toxicity registry.Clinical kidney journal · 2025Article
- Ocular and systemic vascular endothelial growth factor ligand inhibitor use and nephrotoxicity: an update.International urology and nephrology · 2024Review
- Intravitreal ranibizumab injection is associated with an increased risk of chronic kidney disease: a population-based study in Taiwan.Naunyn-Schmiedeberg's archives of pharmacology · 2024Article
- Fruquintinib-induced renal-limited thrombotic microangiopathy: a case report.BMC nephrology · 2024Article
- MicroRNAs as Biomarkers and Therapeutic Targets for Acute Kidney Injury.Diagnostics (Basel, Switzerland) · 2023Review
- Epigallocatechin-3-Gallate, an Active Green Tea Component to Support Anti-VEGFA Therapy in Wet Age-Related Macular Degeneration.Nutrients · 2023Review
- Biocompatible Macroion/Growth Factor Assemblies for Medical Applications.Biomolecules · 2023Review
- Editorial: Be positive about the negative in pharmacology: clinical studies in renal pharmacology 2022.Frontiers in pharmacology · 2023Article
- Overexpression of Plasmalemmal Vesicle-Associated Protein-1 Reflects Glomerular Endothelial Injury in Cases of Proliferative Glomerulonephritis with Monoclonal IgG Deposits.Kidney international reports · 2023Article
- Renal thrombotic microangiopathy and nephrotic proteinuria induced by intravitreal injection of aflibercept for diabetic macular edema.BMC nephrology · 2022Article
- Changes of Estimated Glomerular Filtration Rate and Glycated Hemoglobin A1c in Diabetic Macular Edema Patients Treated by Ranibizumab and Aflibercept in the Tertiary Referral Hospital.Medicina (Kaunas, Lithuania) · 2022Article
- Early biomarkers of nephrotoxicity associated with the use of anti-VEGF drugs.Biomedical reports · 2022Article
- Intravitreal vascular endothelial growth factor inhibitors did not increase the risk of end-stage renal disease in patients with biopsy-proven diabetic kidney disease based on matched study.Frontiers in pharmacology · 2022Article
- VEGF-VEGFR2 inhibitor-associated hyaline occlusive glomerular microangiopathy: a Japanese single-center experience.Clinical and experimental nephrology · 2021Article
- 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
- Unbiased Analysis of Temporal Changes in Immune Serum Markers in Acute COVID-19 Infection With Emphasis on Organ Failure, Anti-Viral Treatment, and Demographic Characteristics.Frontiers in immunology · 2021Article
Corrections and comments
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Authors and funding
16 authors at 8 institutions in 1 country.
Funding
Abstract
Vascular endothelial growth factor (VEGF) inhibition can cause worsening hypertension, proteinuria, chronic kidney injury, and glomerular disease. Thrombotic microangiopathy (TMA) and other nephrotic disorders have been reported with systemic VEGF blockade. These same agents are given intravitreally for age-related macular degeneration (AMD) and diabetic retinopathy (DR), albeit at lower doses than those given for systemic indications. Systemic absorption of anti-VEGF agents when given intravitreally has been shown consistently along with evidence of significant intravascular VEGF suppression. While worsening hypertension has only been seen in some large-scale studies, case reports show worsening proteinuria and diverse glomerular diseases. These include TMA-associated lesions like focal and segmental glomerulosclerosis with collapsing features (cFSGS). In this paper, we report three cases of TMA likely associated with the use of intravitreal anti-VEGF therapy. These patients developed the signature lesion of VEGF blockade in a 6 to 11 month time frame after starting intravitreal VEGF inhibitors. The literature is reviewed showing similar cases. Intravitreal VEGF blockade may cause these adverse events in a hitherto unidentified subgroup of patients. Well-controlled prospective observational trials are needed to determine the event rate and identify which subgroups of patients are at increased risk. A registry for patients who develop worsening hypertension, proteinuria exacerbation, and glomerular diseases from intravitreal VEGF blockade is proposed.
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