PARTNERS WITH
Aflibercept
Anti-angiogenics
MECHANISM OF ACTION
VEGF receptor antibody inhibitor
MECHANISM OF KIDNEY INJURY
TMA (thrombotic microangiopathy) (systemic/kidney limited), Podocyte Injury
CLINICAL KIDNEY SYNDROME
AKI, Proteinuria/Albuminuria, Nephrotic syndrome, Hypertension
Extra-renal, HTN, proteinuria, rash, impaired wound healing
CARDIOVASCULAR ADVERSE EFFECTS
HTN, increase risk of VTE, proteinuria
LYTE ABNORMALITIES
Nephrotic range protenuria
RISK FACTORS
n/a
MITIGATION STRATEGIES
n/a
SUGGESTIONS
Discontinue offending drug, Add ACEi/ARB, Check UA with urine culture, Check urine analysis for cyrstals, WBC, RBC, etc, Check urine protein creatinine ratio, Check GN work up (ANA, ANCA, DsDNA, SPEP with FLC, Hep B sero, Hep C sero, HIV, C3, C4, anti-GBM, cryoglobulins), Check TMA work up (send haptoglobin, peripheral smear, LDH), If TMA, discontinue.
NOTES/COMMENTS
eGFR< 60 ml/min; no dose adjustment
PHARMACOKINETICS
Molecular Weight
115
Volume of Distribution
Plasma Protein Binding
Metabolism
Bioavailability
Half-life elimination
6 days
Time to peak
Excretion
Dialyzable?
Non dialyzable
REF:
doi: 10.1093/ckj/sfab066
PMID: 29318210
PATHOLOGY SLIDES:
ENTRY UPDATES:
Raad Chowdhury
MN/USA
Sep 25, 2022