Table. 1.
Pre-disposing Risk Factors and Renal Complications in Patients on Dasatinib and Ponatinib.
| Drug | Reference | No. of patient | Renal complication | Pre-disposing factors | Case or study background | |||||
|---|---|---|---|---|---|---|---|---|---|---|
| Dasatinib | Ozkurt [3] | 1 | Acute tubular necrosis | None. Labs concerning for pre-renal azotemia 2/2 gastroenteritis so was ruled out as a possible cause of renal failure. | Acute renal failure and gastroenteritis | |||||
| Wallace [4] | 1 | Nephrotic syndrome | None. Discussion includes possible effect of a soluble paraprotein 2/2 CML; cannot be fully ruled out as the cause. | Proteinuria with a kidney biopsy showing chronic thrombotic microangiopathy. | ||||||
| Uz [6] | 1 | Acute renal failure 2/2 rhabdomyolysis | Was initially non-compliant with imatinib. No other chronic diseases or medications that would predispose to rhabdomyolysis or renal failure. | Rhabdomyolysis occurred shortly after the initiation of dasatinib therapy & CK levels normalized after withdrawal of dasatinib. | ||||||
| Kawaguchi [7] | 1 | Massive proteinuria associated with pleural effusion, ascites and HTN | Started on ganciclovir for CMV right before renal event. | Ph+ALL 8 year old female switched to dasatinib secondary to nausea, vomiting, diarrhea on imatinib. | ||||||
| Ochiai [8] | 1 | Nephrotic syndrome | None | Concluded that the main cause of nephrotic syndrome was dasatinib because only switch of the drug improved the patient's proteinuria. | ||||||
| De Luca ML [14] | 1 | Nephrotic range proteinuria with hypercholesteremia | No comorbidities. She was initiated on dasatinib after initially treatment with hydroxyurea | Resolution of proteinuria upon switching to imatinib | ||||||
| Ponatinib | Amin SO [15] | 1 | Renovascular hypertension due to bilateral renal artery stenosis | Smoking history (12 pack year history) and hypertriglyceridemia. | Developed HTN 3 years after starting dasatinib. Responded to revascularization. | |||||
| Hiremath S [16] | 1 | Elevated Cr 2/2 renovascular HTN 2/2 bilateral renal artery stenosis | Responded to revascularization – renal function stabilized | |||||||
2/2 = secondary to; CK = creatinine kinase; CMV = cytomegalovirus; Ph+ ALL= Philadelphia-positive acute lymphoblastic leukemia.