Potential risk and protective factors of bevacizumab induced proteinuria
OBJECTIVE To retrospectively explore the potential risk factors and protective factors of bevacizumab-induced proteinuria,delay the progression of proteinuria and lower the risk of severe kidney injury and other fatal adverse reactions after medication.METHODS From January 2021 to December 2022,331 electronic medical records were retrospectively reviewed for 331 patients receiving bevacizumab injection at Peking University People's Hospital.SPSS27.0 software was utilized for sta-tistical analysis to determine the risk factors related with proteinuria and examine the potential protective factors of hypertension and diabetes mellitus in the past.RESULTS Among them,116(35.05％)were positive for proteinuria and 215 negative.The incidence of grade Ⅱ and above proteinuria was 13.29％.Multivariate Logistic regression analysis indicated that urea nitrogen,kidney disease history,number of medication cycles and concurrent use of epidermal growth factor receptor-tyrosine kinase inhibi-tor(EGFR-TKI)were positively correlated with the occurrence of proteinuria(P＜0.05).Dosing of non-renin angiotensin aldo-sterone system inhibitor(non-RAAS inhibitor)and non-sodium glucose cotransporter 2 inhibitor(non SGLT2i)was correlated positively with proteinuria(P＜0.05).Statistical difference in urea nitrogen was statistically significant in relation to severity of proteinuria(P＜0.05).Combined dosing of RAAS inhibitors and calcium channel blockers(CCB)was correlated negatively with the occurrence of proteinuria(β=-2.065,P＜0.05)and it was a protective factor for previous hypertensive patients.CONCLUSION The incidence of proteinuria caused by bevacizumab is relatively high.When dosing bevacizumab in clinical practices,attention should be paid to baseline urea level,previous kidney diseases,number of medication cycles and concurrent use of EGFR-TKI.Controlling risk factors lowers the risk of severity of bevacizumab-induced proteinuria.For previous hyperten-sive patients,early standardization of RAAS inhibitors plus CCB should be implemented for reducing the occurrence of proteinuria caused by bevacizumab.
NETL
NSTL
万方数据
