| Summary: | Background The prevalence of anticancer drug-induced kidney injury is increasing, but related renal pathology studies are still rare. Objective To analyze the clinicopathological characteristics of patients with anticancer drug-related kidney injury. Methods We selected 112 cancer inpatients aged 18 years or older with kidney injury (kidney injury occurred after cancer or nearly at the same time as cancer, and may be directly or indirectly associated with anticancer treatment) detected by kidney biopsy from Department of Nephrology, the Fourth Hospital of Hebei Medical University from October 2013 to August 2021. We assigned those (n=65) who were previously treated with chemotherapy, molecularly targeted drugs or immune checkpoint inhibitors and other systemic treatments to an anticancer drug group, and other cases (n=47) to a non-use anticancer drug group. We collected their demographics, laboratory examination and pathological data, and analyzed the clinical features and pathological characteristics of kidney of those with anticancer drug-related kidney injury. Results In the anticancer drug group, acute kidney injury (AKI) occurred in 30 (50.8%) out of 59 cases of solid cancer, and in 4 out of 6 cases of hematological cancer. In non-use anticancer drug group, AKI occurred in 11 (31.4%) out of 35 cases of solid cancer, and in 6 (50.0%) out of 12 cases of hematological cancer. The serum creatinine level increased after treatment in the anticancer drug group (P<0.001) . Anticancer drug group and non-use anticancer drug group had significant differences in sex ratio, smoking prevalence, mean serum albumin and elevated urinary protein excretion prevalence (P<0.05) , but had no significant differences in mean age, hemoglobin, serum creatinine, urea nitrogen, uric acid, D-dimer, total cholesterol, triacylglycerol, and 24-hour urinary protein quantification, as well as prevalence of diabetes, hypertension, and AKI (P>0.05) . Solid cancer patients with anticancer drug treatment had higher prevalence of tubulointerstitial injury (P=0.023) and lower prevalence ofmembranous nephrosis (P=0.004) compared with those without anticancer drug treatment. Renal tubulointerstitial injury was the main pathological manifestations in the anticancer drug group〔34 cases (52.3%) 〕. Membranous nephropathy〔18 cases (38.3%) 〕and tubulointerstitial injury〔18 cases (38.3%) 〕were main pathological manifestations in the non-use anticancer drug group. Conclusion There are various clinical and pathological types of anticancer drug-induced kidney injury. The application of anticancer drug may cause damage to renal function, so priority should be given to the prevention of renal tubulointerstitial injury during the treatment.
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