Imatinib

Tyrosine kinase inhibitors

MECHANISM OF ACTION

Cellular TKI, inhibiting BCR-ABL and VEGF

MECHANISM OF KIDNEY INJURY

ATN (Acute tubular necrosis), Crystalline Nephropathy/Tubular obstruction

CLINICAL KIDNEY SYNDROME

AKI incidence is variable (< 1% and up to 7%), Rhabdomyolysis, Hypertension, Fanconi's Syndrome

CARDIOVASCULAR ADVERSE EFFECTS

LYTE ABNORMALITIES

Hypokalemia, Hyponatremia, and hypocalcemia / hypophosphatemia; inhibiting platelet-derived growth factor receptors α and β leading to decreased osteoblast activity

RISK FACTORS

Potentially dose dependent renal injury and history of kidney disease. other risk factors includes DM , old age , and CAD

MITIGATION STRATEGIES

Renally dose

SUGGESTIONS

Hold offending drug and rechallenge after AKI/proteinuria resolves, Discontinue offending drug, Check UA with urine culture

NOTES/COMMENTS

PHARMACOKINETICS

Molecular Weight

Volume of Distribution

Plasma Protein Binding

Metabolism

Bioavailability

Half-life elimination

Time to peak

Excretion

Dialyzable?

REF:

PMID: 15883819
PMID: 29318210, https://doi.org/10.5301/jo-n.500000

PATHOLOGY SLIDES:

ENTRY UPDATES:

Raad Chowdhury

MN/USA

Sep 25, 2022

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