{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T19:55:04Z","timestamp":1778788504430,"version":"3.51.4"},"reference-count":13,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2021,3,2]],"date-time":"2021-03-02T00:00:00Z","timestamp":1614643200000},"content-version":"unspecified","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,1,25]]},"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:p>Ramucirumab-induced renal dysfunction is rarely reported. The pathology of ramucirumab-associated nephropathy in past reports primarily shows thrombotic microangiopathy (TMA) lesions but podocytopathy is not yet known. We report a case of kidney injury induced by ramucirumab in a 71-year-old man with cecal cancer. He was referred to our department for increasing serum creatinine (Cr) levels from 1.08 mg\/dL to 2.56 mg\/dL after changing anticancer drugs from bevacizumab to ramucirumab. He showed nephrotic-range proteinuria (12.1 g\/gCr). A renal biopsy revealed endothelial cell injuries, such as TMA and podocytopathy with epithelial cell hyperplasia, which looked like a crescent. After discontinuing ramucirumab, his renal function and proteinuria improved, as seen by his Cr levels and proteinuria which decreased to 1.74\u2009mg\/dL and 1.21\u2009g\/gCr, respectively, in 3\u2009months. Unlike previous reports, we found that ramucirumab caused podocyte injuries.<\/jats:p>","DOI":"10.1136\/bcr-2020-239603","type":"journal-article","created":{"date-parts":[[2021,3,2]],"date-time":"2021-03-02T10:57:56Z","timestamp":1614682676000},"page":"e239603","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["A case of ramucirumab-induced renal failure with nephrotic-range proteinuria and its pathological findings"],"prefix":"10.1136","volume":"14","author":[{"given":"Yuta","family":"Nakano","sequence":"first","affiliation":[{"name":"Nephrology, Yokohama City Minato Red Cross Hospital, Yokohama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiro","family":"Kumagai","sequence":"additional","affiliation":[{"name":"Pathology, Yokohama City Minato Red Cross Hospital, Yokohama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kiyotaka","family":"Nagahama","sequence":"additional","affiliation":[{"name":"Pathology, Kyorin University, Mitaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hajime","family":"Fujisawa","sequence":"additional","affiliation":[{"name":"Nephrology, Yokohama City Minato Red Cross Hospital, Yokohama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,3,2]]},"reference":[{"key":"2025082804211477000_14.3.e239603.1","doi-asserted-by":"crossref","first-page":"2932","DOI":"10.1093\/annonc\/mdx514","article-title":"Meta-analysis of individual patient safety data from six randomized, placebo-controlled trials with the antiangiogenic VEGFR2-binding monoclonal antibody ramucirumab","volume":"28","author":"Arnold","year":"2017","journal-title":"Ann Oncol"},{"key":"2025082804211477000_14.3.e239603.2","first-page":"267","article-title":"Kidney injury during VEGF inhibitor therapy","volume":"70","author":"den Deurwaarder","year":"2012","journal-title":"Neth J Med"},{"key":"2025082804211477000_14.3.e239603.3","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000016236","article-title":"Nephrotic syndrome associated with ramucirumab therapy: a single-center case series and literature review","volume":"98","author":"Fujii","year":"2019","journal-title":"Medicine"},{"key":"2025082804211477000_14.3.e239603.4","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2006030225"},{"key":"2025082804211477000_14.3.e239603.5","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfu368"},{"key":"2025082804211477000_14.3.e239603.6","doi-asserted-by":"publisher","DOI":"10.1152\/ajprenal.00275.2009"},{"key":"2025082804211477000_14.3.e239603.7","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2018080853"},{"key":"2025082804211477000_14.3.e239603.8","doi-asserted-by":"crossref","DOI":"10.1186\/s12882-018-1194-9","article-title":"Renal-limited thrombotic microangiopathy after switching from bevacizumab to ramucirumab: a case report","volume":"20","author":"Yamada","year":"2019","journal-title":"BMC Nephrol"},{"key":"2025082804211477000_14.3.e239603.9","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000000333"},{"key":"2025082804211477000_14.3.e239603.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2016.10.005"},{"key":"2025082804211477000_14.3.e239603.11","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2010030295"},{"key":"2025082804211477000_14.3.e239603.12","doi-asserted-by":"publisher","DOI":"10.1074\/jbc.M111.241620"},{"key":"2025082804211477000_14.3.e239603.13","doi-asserted-by":"crossref","first-page":"1462","DOI":"10.1093\/neuonc\/noy103","article-title":"VEGF-C sustains VEGFR2 activation under bevacizumab therapy and promotes glioblastoma maintenance","volume":"20","author":"Michaelsen","year":"2018","journal-title":"Neuro Oncol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2020-239603","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T11:21:24Z","timestamp":1756380084000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2020-239603"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3]]},"references-count":13,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2021,3,2]]},"published-print":{"date-parts":[[2021,3]]}},"alternative-id":["10.1136\/bcr-2020-239603"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2020-239603","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3]]}}}