舒尼替尼致孤立肾患者急性肾损伤病例分析

中国医药导刊 ›› 2025, Vol. 27 ›› Issue (4): 391-394.

舒尼替尼致孤立肾患者急性肾损伤病例分析

单彬^1a，李晖^1b，侯娟^1a，尹金妥^1a，吕雨科²，付晴晴²，陈梦如²，郭静汝²，问天娇^1a*

1.河北医科大学第四医院药学部^a，肾内科^b，河北石家庄 050011；
2.河北医科大学药学院，河北石家庄 050011

收稿日期:2024-10-25 修回日期:2025-03-20 出版日期:2025-04-28 发布日期:2025-04-28
基金资助:
河北省医学科学研究课题计划资助（20240159）；河北省医学科学研究课题计划资助（20230892）；河北医科大学临床药学青年学者托举项目——星火计划（XHJH202304）；河北医科大学2023年大学生创新性实验计划项目（USIP2023373）

Case Analysis of Sunitinib Induced Acute Kidney Injury in Patients with Solitary Kidney

1.Department of Pharmacy^a， Department of Nephrology^b， the Fourth Hospital of Hebei Medical University，
Hebei Shijiazhuang 050011， China； 2.College of Pharmacy， Hebei Medical University，Hebei Shijiazhuang 050011， China

Received:2024-10-25 Revised:2025-03-20 Online:2025-04-28 Published:2025-04-28
Supported by:

摘要/Abstract

摘要：

血管内皮生长因子（vascular endothelial growth factor，VEGF）信号通路抑制剂是转移性肾透明细胞癌的一线治疗药物，其导致肾脏损伤的病例已有报道，但孤立肾患者应用VEGF小分子靶向抑制剂出现急性肾损伤（acute kidney injury， AKI）的报道很少，本研究通过文献复习仅发现2例舒尼替尼导致孤立肾患者AKI的病例报道。孤立肾患者应用小分子靶向药的安全性值得深入研究。本研究介绍1例孤立肾患者应用VEGF小分子靶向抑制剂舒尼替尼后发生AKI的病例，患者以恶心呕吐、肌酐升高、蛋白尿为主要临床表现，评价为AKI 3期，不良反应4级，停用舒尼替尼，予以抑酸、改善肾脏血液循环、降尿素氮等治疗后肌酐下降，主诉无不适出院，后期随访患者肌酐恢复正常。本研究详述了舒尼替尼导致AKI的机制、肾损伤的病理类型及孤立肾患者AKI发生的特殊性等，旨在提示临床孤立肾患者应用小分子靶向药物应考虑到药代动力学的变化，密切监测肾功能，提高靶向药在孤立肾患者中的用药安全。

关键词: 舒尼替尼, 急性肾损伤, 孤立肾, 药物不良反应

Abstract:

Inhibitors of the vascular endothelial growth factor （VEGF） signaling pathway are first-line treatments for metastatic clear cell renal cell carcinoma. Cases of renal injury caused by VEGF inhibitors have been reported， however， there are few reports of acute kidney injury （AKI） in patients with solitary kidney treated with small molecule inhibitors of VEGF. Through literature review in this study， only 2 case reports of AKI in patients with solitary kidney caused by sunitinib were found. The safety of small molecule targeted agent in patients with solitary kidney deserves further study. A case of AKI following the use of sunitinib （a small molecule targeted inhibitor of VEGF） in patient with solitary kidney was reported in this study. The main clinical manifestations of the patient were nausea and vomiting， elevated creatinine level， and proteinuria. Evaluation revealed stage 3 AKI and grade 4 adverse drug reactions. After the treatment of discontinuation of sunitinib， acid suppression therapy， improving renal blood circulation， and reduction of urea nitrogen levels， the patient's creatinine level decreased and discharged from the hospital. Subsequent follow-up showed that the creatinine level of the patient returned to noral. This study provides detailed information on the mechanism of sunitinib leading to AKI， the pathological type of renal injury， and the particularity of AKI in patients with solitary kidney. It is emphasized that pharmacokinetic changes should be considered in the application of small molecule targeted agents in patients with solitary kidney， and their renal function should be closely monitored to ensure medication safety.

Key words: , Sunitinib； , Acute kidney injury； , Solitary kidney； , Adverse drug reaction

中图分类号:

R692
R96

单彬a, 李晖b, 侯娟a, 尹金妥a, 吕雨科, 付晴晴, 陈梦如, 郭静汝, 问天娇a.

舒尼替尼致孤立肾患者急性肾损伤病例分析 [J]. 中国医药导刊, 2025, 27(4): 391-394.

SHAN Bina, LI Huib, HOU Juana, YIN Jintuoa, LV Yuke, FU Qingqing, CHEN Mengru, GUO Jingru, WEN Tianjiaoa.

Case Analysis of Sunitinib Induced Acute Kidney Injury in Patients with Solitary Kidney [J]. CHINESE JOURNAL OF MEDICINAL GUIDE, 2025, 27(4): 391-394.

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