Table 2.

Clinical approach to renal adverse effects of ALK inhibitors

Adverse event	Mechanism	Management
Renal cyst	Unknown	Self-limiting, not to be confused with tumor progression
Peripheral edema	Inhibition of c-MET	Diuretics only to be used if severe edema. Be mindful of electrolyte imbalances
Elevated serum creatinine	Pseudo AKI, ATN	Check Cystatin Cbased glomerular filtration rate to rule out pseudo-AKI. If ATN, drug needs to be withheld
Proteinuria	Likely podocytopathies	Consider holding or decreasing dose