Vascular Endothelial Growth Factor Inhibitor Therapy and Cardiovascular and Renal Damage in Renal Cell Carcinoma.

Abstract: Background: Sunitinib, a tyrosine kinase inhibitor of vascular endothelial growth factor (VEGF), is approved for first and second line treatment of advanced renal cell carcinoma (RCC). Knowledge on the effects of sunitinib on cardiovascular (CV) risk and renal damage is limited. Aim: To evaluate possible renal and CV damage in patients with RCC treated with sunitinib. Materials and Methods: Patients with metastatic RCC treated with sunitinib were enrolled. This popu- lation was evaluated before starting treatment (T0) and after 3 months (T1). Laboratory and instrumen- tal parameters, including interventricular septum (IVS) and left ventricular mass index (LVMI) were recorded before and after treatment. Results: Thirty-two patients (13 female, 19 male, mean age 62.7±9.9 years) were enrolled. We observed overtime, a significant reduction in estimated glomerular filtration rate (eGFR) (p=0.01), hemoglobin (Hb) (p=0.04) and 25-hydroxyvitamin D (25-OH-VitD) (p=0.002), in association with a significant increase in serum phosphorus (p<0.001), systolic blood pressure (SBP) (p<0.001), diastolic blood pres- sure (DBP) (p<0.001), IVS (p=0.03) and proteinuria (p