Abstract: SA-PO1276
Kidney Biopsy Enables Accurate Diagnosis of Antivascular Endothelial Growth Factor (VEGF)-Related Kidney Toxicity
Session Information
- Onconephrology: Epidemiological Trends, Risk Stratification, and Clinical Outcomes
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Onconephrology
- 1600 Onconephrology
Authors
- Fenoglio, Roberta, Ospedale San Giovanni Bosco, Turin, Piedmont, Italy
- Roccatello, Dario, Ospedale San Giovanni Bosco, Turin, Piedmont, Italy
- Sciascia, Savino, Ospedale San Giovanni Bosco, Turin, Piedmont, Italy
Background
Targeted therapies (TTs), tyrosine kinase inhibitors (TKIs), and immune based anticancer agents frequently cause renal adverse events such as acute kidney injury (AKI) and proteinuria. Kidney biopsy is often deferred due to bleeding risk, especially in patients receiving antiVEGF agents. However, recent evidence shows that even brief interruptions of TKI therapy may lead to rapid oncologic progression, including early molecular relapse in chronic myeloid leukemia and tumor flare in metastatic renal cell carcinoma. Balancing procedural risk with oncologic safety is therefore essential.
Methods
We conducted a retrospective single center study of 34 oncologic patients treated with TTs who underwent kidney biopsy (2018 – 2025). Clinical, laboratory, and histologic data were collected at biopsy. Outcomes included histologic diagnosis, modifications of anticancer therapy, and renal follow up
Results
Biopsy revealed glomerular lesions in 82.4% of cases and tubulointerstitial injury in 17.7%. Thrombotic microangiopathy (with or without FSGS) was the most frequent pattern (44%), predominantly associated with antiVEGF agents. Biopsy findings guided management: TT was continued in 64% of patients, modified in 35.2%, and permanently discontinued in 14.7%. Only one patient progressed to dialysis; deaths were unrelated to renal toxicity.
Conclusion
Kidney biopsy provides essential diagnostic and therapeutic guidance in TT associated renal injury, preventing unnecessary treatment discontinuation and avoiding inappropriate immunosuppression. Findings support expanding biopsy indications in oncologic patients with AKI or significant proteinuria.