Kidney Week

Abstract: PUB008

Renal Damage Associated with Intravitreal Administration of Anti-VEGF Drugs

Session Information

• Publication Only

Category: Acute Kidney Injury

• 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

• Fernández vidal, María, Hospital Universitario 12 de Octubre, Madrid, Spain

María Fernández vidal,

• Moliz, Candela, Hospital Universitario 12 de Octubre, Madrid, Spain

Candela Moliz,

• Redondo navarro, Beatriz, Hospital Universitario 12 de Octubre, Madrid, Spain

Beatriz Redondo navarro,

• Canllavi fiel, Elizabeth, Hospital Universitario 12 de Octubre, Madrid, Spain

Elizabeth Canllavi fiel,

• Bada Bosch, Teresa, Hospital Universitario 12 de Octubre, Madrid, Spain

Teresa Bada Bosch,

• Trujillo Cuellar, Hernando, Hospital Universitario 12 de Octubre, Madrid, Spain

Hernando Trujillo Cuellar,

• Aubert, Lucia, Hospital Universitario 12 de Octubre, Madrid, Spain

Lucia Aubert,

• Sandino Perez, Justo, Hospital Universitario 12 de Octubre, Madrid, Spain

Justo Sandino Perez,

• Morales, Enrique, Hospital Universitario 12 de Octubre, Madrid, Spain

Enrique Morales,

Background

Vascular endothelial growth factor inhibitors (anti-VEGF) have been shown to be effective in the treatment of macular degeneration and diabetic macular edema. It is known that systemic administration of these drugs can produce adverse renal effects, such as decreased glomerular filtration rate (eFGR), proteinuria, hypertension or thrombotic microangiopathy. However, there is little information about it when the administration is intravitreal.

Methods

We analyzed the effect of anti-VEGF drugs with intravitreal administration on eFGR and proteinuria in diabetic patients, with and without chronic kidney disease (CKD), between 2017 and 2018.

Results

We included 40 diabetic patients (58% males) with a mean age of 74 ± 11.93 years, 92.7% being hypertensive and presenting 65.9% of the cases with CKD. 58.5% received bevazicumab, while the remaining 41.5% received ranibizumab. The evolution of eFGR and proteinuria are described in Table 1, where it stands out the increase in albuminuria and the decrease in eFGR in patients without previous CKD.
Regarding the drug type, there were no differences but it is noteworthy that bevazicumab brushed the statistical significance (p 0.066) for the increase in albuminuria with respect to ranibizumab.
On the other hand, within the CKD group, one patient presented two episodes of decompensation of heart failure after administration of an anti-VEGF drug, and two required the initiation of renal replacement therapy.

Conclusion

Based on the results of our cohort, we believe that it would be advisable to establish a closer monitoring in diabetic patients who are administered an intravitreal anti-VEGF drug, with determination of renal function as well as proteinuria to establish an early diagnosis of possible complications.