Wcn24-1742 Totally Harmless or Slow Burn: How Do We Interpret Changes in Serum Creatinine From Molecularly-Targeted Cancer Therapies?

Many anti-cancer medications inhibit tubular creatinine excretion, thereby increasing serum creatinine without causing acute kidney damage ("pseudo-kidney injury") including cyclin dependent kinase 4/6, poly ADP ribose polymerase (PARP), and specific tyrosine kinase inhibitors. The long-term effect of this blockade is largely unknown and these same drugs also block growth factors that mediate cell proliferation, resulting in damage of renal tubular epithelium.These medications include first-line therapies for lung, breast, and kidney cancer and once initiated, patients remain on these daily oral medications for years during which time clinicians struggle to distinguish "pseudo-kidney injury" from true nephrotoxicity that may progress to chronic kidney disease (CKD).