{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T13:38:07Z","timestamp":1792676287496,"version":"4.5.0"},"reference-count":0,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T00:00:00Z","timestamp":1792627200000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Hypothesis<\/jats:title>\n                    <jats:p>Thrombotic microangiopathy (TMA) is increasingly recognized as a complication of both cancer and anti-cancer therapies. C5 complement inhibition is used in selected cases, but evidence supporting its effectiveness, particularly in kidney biopsy-proven disease, remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study included adult patients with biopsy-proven TMA attributed to anti-cancer therapies between 2015 and 2026 at Mayo Clinic, USA. Patients were stratified according to treatment with complement inhibition versus no complement inhibition therapy. The primary outcome was renal recovery; secondary outcomes included hematological recovery, composite outcome, overall survival, and longitudinal changes in hematologic and renal function parameters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 31 patients with kidney biopsy-proven TMA related to anti-cancer therapy were included. Nine received complement inhibition, and 22 did not. A higher proportion of patients in the treated group achieved complete or partial renal recovery at 3 months (p\u00a0=\u00a00.008), hematologic recovery at 1 month (p\u00a0=\u00a00.007) and composite outcome (complete-partial renal plus hematologic recovery) (p\u00a0=\u00a00.041). During follow-up, platelet counts increased significantly at 1 month and 3 months (p\u00a0=\u00a00.045, both) in the treated group. Mixed-effects modeling showed significantly lower longitudinal estimated glomerular filtration rate (eGFR) values in the untreated group (\u03b2 = \u221213.9\u00a0mL\/min per 1.73 m\u00b2, p\u00a0=\u00a00.028). In the gemcitabine-associated TMA subgroup, complete-partial renal recovery occurred only in treated patients (p\u00a0=\u00a00.021) and hematologic recovery was achieved in the whole cohort but occurred significantly faster in the complement inhibition group (p\u00a0=\u00a00.019). The higher rate of renal recovery persisted in sensitivity analysis (p\u00a0=\u00a00.021).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this rigorously phenotyped cohort of patients with biopsy-proven, anti-cancer therapy-associated renal TMA, we observed a signal of benefit from C5 inhibition, most consistently for renal recovery and possibly extending to hematologic outcomes, particularly among patients with gemcitabine-associated TMA.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ndt\/gfag246","type":"journal-article","created":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T11:48:09Z","timestamp":1792583289000},"source":"Crossref","is-referenced-by-count":0,"title":["C5 Inhibition for Anti-Cancer Therapy-Induced Renal Thrombotic Microangiopathy"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-0548-476X","authenticated-orcid":false,"given":"Michele","family":"Barbarini","sequence":"first","affiliation":[{"name":"Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic , Rochester, MN ,","place":["USA"]},{"name":"Nephrology Unit, Department of Medicine and Surgery, University of Parma , Parma ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2663-7301","authenticated-orcid":false,"given":"Coraima Nava","family":"Chavez","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic , Rochester, MN ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pouneh","family":"Mirkheshti","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic , Rochester, MN ,","place":["USA"]},{"name":"Charit\u00e9 - Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin Department of Nephrology and Medical Intensive Care, , Berlin ,","place":["Germany"]},{"name":"Deutsches Rheuma-Forschungszentrum, Institute of the Leibniz Foundation , Berlin ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charat","family":"Thongprayoon","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic , Rochester, MN ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald S","family":"Go","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Medicine, Mayo Clinic , Rochester, MN ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7225-8228","authenticated-orcid":false,"given":"Meera","family":"Sridharan","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Medicine, Mayo Clinic , Rochester, MN ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loren P","family":"Herrera Hernandez","sequence":"additional","affiliation":[{"name":"Mayo Clinic Department of Laboratory Medicine and Pathology, , Rochester, MN ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5651-1411","authenticated-orcid":false,"given":"Nelson","family":"Leung","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic , Rochester, MN ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3700-4537","authenticated-orcid":false,"given":"Sandra M","family":"Herrmann","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic , Rochester, MN ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,10,22]]},"container-title":["Nephrology Dialysis Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ndt\/advance-article-pdf\/doi\/10.1093\/ndt\/gfag246\/72350848\/gfag246.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ndt\/advance-article-pdf\/doi\/10.1093\/ndt\/gfag246\/72350848\/gfag246.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T12:43:16Z","timestamp":1792672996000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ndt\/advance-article\/doi\/10.1093\/ndt\/gfag246\/8978728"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,22]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1093\/ndt\/gfag246","relation":{},"ISSN":["0931-0509","1460-2385"],"issn-type":[{"value":"0931-0509","type":"print"},{"value":"1460-2385","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,22]]},"article-number":"gfag246"}}