Long term outcomes of bevacizumab-associated kidney adverse effects

Bevacizumab is an anti-angiogenic monoclonal antibody against vascular endothelial growth factor (VEGF) and has multiple indications with known renal adverse effects, notably proteinuria, and acute kidney injury (AKI). There is insufficient knowledge about the long-term outcomes of its renal adverse effects. In this retrospective study, we reviewed the clinical course of all patients who received bevacizumab and developed therapy associated AKI, chronic kidney disease (CKD), or proteinuria. Among the 1,506 patients who received bevacizumab, the renal events attributed to bevacizumab were: 125 episodes of AKI (8.3%), 110 new-onset proteinuria events (7.3%), and new onset CKD in 112 patients (7.4%). All patients with bevacizumab-associated AKI recovered without requiring renal replacement therapy and in most patients (59%), the renal function returned to baseline. In conclusion, bevacizumab associated renal adverse effects were a common occurrence but with minimal long term adverse outcomes considering that this population is significantly impacted by their cancer prognosis. These results are helpful during counseling regarding risks and benefits of therapy discontinuation in patients who develop bevacizumab-associated adverse effects.