Observational studyOphthalmology. Retina2024
Similar Risk of Kidney Failure among Patients with Blinding Diseases Who Receive Ranibizumab, Aflibercept, and Bevacizumab: An Observational Health Data Sciences and Informatics Network Study.
Observational study in Ophthalmology. Retina, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 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
- Semaglutide and Neovascular Age-Related Macular Degeneration among Adults with Type 2 Diabetes: An Observational Health Data Sciences and Informatics Network Study.Ophthalmology · 2026Observational
- From study design to executable code: automating target trial emulation with large language models.JAMIA open · 2026Article
- Semaglutide and diabetic retinopathy: an OHDSI network study.BMJ open diabetes research & care · 2025 · on this mapObservational
- Intravitreal vascular endothelial growth factor inhibitor systemic and renal toxicity registry.Clinical kidney journal · 2025Article
- Systemic Effects of Intravitreal Anti-VEGF Therapy: A Review of Safety across Organ Systems.Ophthalmology and therapy · 2025Review
- Report of the 2023 Mary Tyler Moore Vision Initiative Workshop.Translational vision science & technology · 2025Article
- The OHDSI Network in Ophthalmology-The Promise of Observational Health Data.JAMA ophthalmology · 2025Article
- Breach and restoration of retinal immune privilege: barrier failure, innate dysregulation, and adaptive autoimmunity.Frontiers in immunology · 2025Review
- Data Harmonization, Standardization, and Collaboration for Diabetic Retinal Disease (DRD) Research: Report From the 2024 Mary Tyler Moore Vision Initiative Workshop on Data.Translational vision science & technology · 2024Article
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Authors and funding
37 authors at 17 institutions in 3 countries.
Funding
Abstract
purposeTo characterize the incidence of kidney failure associated with intravitreal anti-VEGF exposure; and compare the risk of kidney failure in patients treated with ranibizumab, aflibercept, or bevacizumab.
designRetrospective cohort study across 12 databases in the Observational Health Data Sciences and Informatics (OHDSI) network. SUBJECTS: Subjects aged ≥ 18 years with ≥ 3 monthly intravitreal anti-VEGF medications for a blinding disease (diabetic retinopathy, diabetic macular edema, exudative age-related macular degeneration, or retinal vein occlusion).
methodsThe standardized incidence proportions and rates of kidney failure while on treatment with anti-VEGF were calculated. For each comparison (e.g., aflibercept versus ranibizumab), patients from each group were matched 1:1 using propensity scores. Cox proportional hazards models were used to estimate the risk of kidney failure while on treatment. A random effects meta-analysis was performed to combine each database's hazard ratio (HR) estimate into a single network-wide estimate.
main outcome measuresIncidence of kidney failure while on anti-VEGF treatment, and time from cohort entry to kidney failure.
resultsOf the 6.1 million patients with blinding diseases, 37 189 who received ranibizumab, 39 447 aflibercept, and 163 611 bevacizumab were included; the total treatment exposure time was 161 724 person-years. The average standardized incidence proportion of kidney failure was 678 per 100 000 persons (range, 0-2389), and incidence rate 742 per 100 000 person-years (range, 0-2661). The meta-analysis HR of kidney failure comparing aflibercept with ranibizumab was 1.01 (95% confidence interval [CI], 0.70-1.47; P = 0.45), ranibizumab with bevacizumab 0.95 (95% CI, 0.68-1.32; P = 0.62), and aflibercept with bevacizumab 0.95 (95% CI, 0.65-1.39; P = 0.60).
conclusionsThere was no substantially different relative risk of kidney failure between those who received ranibizumab, bevacizumab, or aflibercept. Practicing ophthalmologists and nephrologists should be aware of the risk of kidney failure among patients receiving intravitreal anti-VEGF medications and that there is little empirical evidence to preferentially choose among the specific intravitreal anti-VEGF agents. FINANCIAL DISCLOSURES: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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