Evidence map›Paper›PMID 41196597›Full record

ArticleJAMA network open2025

Molecularly Targeted Cancer Medications and Kidney Health.

Susan Ziolkowski, Jin Long, Yutong Zhong, Hannah Morgan-Cooper, Heather Wakelee, Ali Khaki, Fauzia Riaz, Sunil Reddy, Mary Leonard, Shuchi Anand

Erratum issuedAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in JAMA network open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Susan ZiolkowskiDepartment of Medicine, Nephrology, Stanford University, Stanford, California.
Jin LongDepartment of Pediatrics, Stanford University, Stanford, California.
Yutong ZhongDepartment of Pediatrics, Stanford University, Stanford, California.
Hannah Morgan-CooperStanford Healthcare, Stanford University, Stanford, California.
Heather WakeleeDepartment of Medicine, Oncology, Stanford University, Stanford, California.
Ali KhakiDepartment of Medicine, Oncology, Stanford University, Stanford, California.
Fauzia RiazDepartment of Medicine, Oncology, Stanford University, Stanford, California.
Sunil ReddyDepartment of Medicine, Oncology, Stanford University, Stanford, California.
Mary LeonardDepartment of Pediatrics, Stanford University, Stanford, California.
Shuchi AnandDepartment of Medicine, Nephrology, Stanford University, Stanford, California.

Funding

Integrating machine learning to improve kidney disease risk assessment for patients on cancer therapyK23DK141988 · NIDDK · STANFORD UNIVERSITY · PI Susan Ziolkowski · 2025 to 2026
$384k
NIDDK NIH HHS K23 DK141988
6 · The paper itself

Abstract

Importance: Oral molecularly targeted cancer medications are widely used. Product labels describe an increase in serum creatinine (sCr), potentially due to reversible inhibition of tubular creatinine secretion rather than acute kidney injury. Objective: To determine the 2-year incidence and relative rates of progressive kidney dysfunction in patients treated with molecularly targeted cancer medications associated with an acute change in sCr handling (pseudoacute kidney injury). Design, Setting, and Participants: Retrospective cohort study of adult patients throughout the San Francisco Bay area treated at Stanford Hospital and clinics since 2008 receiving cyclin dependent kinase 4 or 6 (CDK4/6) inhibitors, poly(adenosine diphosphate-ribose) polymerase inhibitors, and specific drugs within tyrosine kinases inhibitor subgroups with an available estimated glomerular filtration rate (eGFR) from days 1 to 60 after drug start compared with propensity score-matched patients without cancer. Exposure: Molecularly targeted cancer medications associated with an acute change in sCr. Main outcomes and measures: Progressive kidney dysfunction defined as a sustained 30% or more decline in eGFR or reaching end-stage kidney disease, accounting for a potentially reversible rise in sCr at drug start by defining baseline eGFR as the mean value from days 1 to 60 after drug start. Results: Among 5015 patients in the treated cohort, the median (IQR) age was 62 (51-72) years, 3264 (65%) were female, and the mean (SD) baseline eGFR before drug start was 87 (23) mL/min/1.73m2. Using cox proportional hazards regression models, the overall incidence and rate of progressive kidney dysfunction was higher in the treated cohort than in propensity-matched cohorts of patients without cancer (44 vs 38 per 1000 person-years; hazard ratio [HR], 1.4; 95% CI, 1.2-1.6). Rates of kidney dysfunction were higher among patients treated with CDK4/6 inhibitors (HR, 1.9; 95% CI, 1.4-2.6), estimated glomerular filtration rate inhibitors (HR, 1.8; 95% CI, 1.2-2.5), vascular endothelial growth factor receptor inhibitors (HR, 2.1; 95% CI, 1.6-2.7), and B-Raf inhibitors (HR, 1.9; 95% CI, 1.1-3.3) compared with controls. These higher rates persisted in patients without a 20% or more increase in sCr at drug start and without exposure to chemotherapy or immunotherapy. Conclusions and relevance: In this cohort study of patients treated with molecularly targeted anticancer medications associated with an acute rise in sCr, we observed higher incidence and relative rate for kidney dysfunction among treated patients, compared with matched cancer-free patients.

Indexed as

Acute Kidney InjuryAntineoplastic AgentsMolecular Targeted TherapyNeoplasmsAgedCreatinineFemaleGlomerular Filtration RateHumansIncidenceMaleMiddle AgedProtein Kinase InhibitorsRetrospective StudiesSan FranciscoAntineoplastic AgentsCreatinineProtein Kinase Inhibitors

Identifiers

PMID41196597
PMCPMC12593116

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.