VEGF (vascular endothelial growth factor) receptortyrosine kinase inhibitors have become frst-line therapyfor metastatic renal cell carcinoma. Their use commonlyleads to hypertension, but their effects on long-term renalfunction are not known. In addition, it has been suggestedthat the development of hypertension is linked to treatmenteffcacy. The objective of this study was to determine theeffects of these drugs on long-term renal function, especiallyin those with renal dysfunction at baseline, and to examinethe role of hypertension on these effects. Serum creatininemeasurements were used to calculate the estimated glomerularfltration rate for 130 renal cell carcinoma patients who weretreated with this class of tyrosine kinase inhibitors. New orworsening hypertension was defned by documented startor addition of antihypertensive medications. Overall, theuse of tyrosine kinase inhibitors in patients with estimatedglomerular fltration <60 or ≥60 mL/minute per 1.73 m2 wasnot associated with a decline in long-term renal function.During follow-up, 41 patients developed new or worseninghypertension within 30 days from frst drug administration,and this was not linked to further reductions in glomerularfltration. These patients seemed to survive longer than thosewho did not develop hypertension within 30 days, althoughthis was not statistically signifcant (P=0.07). Our fndingssuggest that the use of VEGF tyrosine kinase inhibitors doesnot adversely affect long-term renal function even in thesetting of new-onset hypertension or reduced renal functionat baseline.
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机译：VEGF（血管内皮生长因子）受体酪氨酸激酶抑制剂已成为转移性肾细胞癌的首选疗法。它们的使用通常会导致高血压，但它们对长期肾功能的影响尚不清楚。另外，已经提出高血压的发展与治疗效果有关。这项研究的目的是确定这些药物对长期肾功能的影响，尤其是在基线时患有肾功能不全的那些患者，并研究高血压对这些作用的作用。血清肌酐测量用于计算130例用此类酪氨酸激酶抑制剂治疗的肾细胞癌患者的肾小球滤过率。有记录的开始添加降压药可以预防新的恶化的高血压。总体而言，在估计的肾小球搏动每分钟1.73 m2小于或等于60 mL / min的患者中使用酪氨酸激酶抑制剂与长期肾功能的下降无关。在随访期间，有41例患者在30天后出现新的或恶化的高血压首次给药，与进一步降低肾小球滤过率没有关系。这些患者的生存期似乎比那些在30天内未患高血压的患者生存时间更长，尽管这在统计学上并不显着（P = 0.07）。我们的研究结果表明，即使在新发高血压或基线肾功能降低的情况下，使用VEGF酪氨酸激酶抑制剂也不会对长期肾功能产生不利影响。
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