{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T22:25:45Z","timestamp":1793226345610,"version":"4.5.0"},"reference-count":14,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,5,12]]},"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:p>Targeted therapy-induced acute kidney injury (AKI) can complicate oncologic treatment. We present a case of creatinine elevation induced by abemaciclib, a cyclin-dependent kinases 4 and 6 inhibitor used in advanced breast cancer which can also cause nephrotoxicity. A female patient in her mid-sixties was referred to nephrology for elevated serum creatinine after starting abemaciclib. Diagnostic workup, including blood urea nitrogen (BUN), serum cystatin C, urine protein measurement, and serum electrolytes revealed no evidence of renal dysfunction. This case emphasises the importance of distinguishing creatinine elevation from true nephrotoxicity to avoid unnecessary treatment adjustments. Abemaciclib and other targeted therapies can induce creatinine elevation by inhibiting proximal tubule secretory transporters, rather than through direct nephrotoxicity. By incorporating additional assessments such as BUN, serum cystatin C, and additional biomarkers including urinary neutrophil gelatinase-associated lipocalin and kidney injury molecule 1, clinicians can distinguish creatinine elevation from AKI to guide appropriate management of oncologic diseases.<\/jats:p>","DOI":"10.1136\/bcr-2024-261725","type":"journal-article","created":{"date-parts":[[2025,5,31]],"date-time":"2025-05-31T02:30:15Z","timestamp":1748658615000},"page":"e261725","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Abemaciclib-Induced Pseudo-AKI: an underrecognised finding"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-8826-268X","authenticated-orcid":false,"given":"Payton","family":"Markley","sequence":"first","affiliation":[{"name":"Medicine, The University of Kansas School of Medicine-Wichita, Wichita, Kansas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salam","family":"Kadhem","sequence":"additional","affiliation":[{"name":"Kansas Nephrology Physicians, Wichita, Kansas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Moore","sequence":"additional","affiliation":[{"name":"Cancer Center of Kansas, Wichita, Kansas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,5,30]]},"reference":[{"key":"2025082801231923000_18.5.e261725.1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ki.5002786"},{"key":"2025082801231923000_18.5.e261725.2","doi-asserted-by":"crossref","first-page":"684","DOI":"10.1038\/s41379-018-0186-4","article-title":"Bevacizumab-associated glomerular microangiopathy","volume":"32","author":"Person","year":"2019","journal-title":"Mod Pathol"},{"key":"2025082801231923000_18.5.e261725.3","unstructured":"Makris K , Spanou L . n.d. Acute Kidney Injury: Definition, Pathophysiology and Clinical Phenotypes. Acute Kidney Injury."},{"key":"2025082801231923000_18.5.e261725.4","doi-asserted-by":"crossref","first-page":"1364","DOI":"10.1093\/ckj\/sfaa008","article-title":"Acute interstitial nephritis associated with immune checkpoint inhibitors: a single-centre experience","volume":"14","author":"Oleas","year":"2021","journal-title":"Clin Kidney J"},{"key":"2025082801231923000_18.5.e261725.5","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1093\/ckj\/sfad011","article-title":"Pseudo-AKI associated with targeted anti-cancer agents-the truth is in the eye of the filtration marker","volume":"16","author":"Vanhoutte","year":"2023","journal-title":"Clin Kidney J"},{"key":"2025082801231923000_18.5.e261725.6","unstructured":"VERZENIOTm (abemaciclib) tablets, for oral use. 2017."},{"key":"2025082801231923000_18.5.e261725.7","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1016\/j.ekir.2021.11.033","article-title":"Clinicopathologic Features of Acute Kidney Injury Associated With CDK4\/6 Inhibitors","volume":"7","author":"Gupta","year":"2022","journal-title":"Kidney Int Rep"},{"key":"2025082801231923000_18.5.e261725.8","doi-asserted-by":"crossref","first-page":"1187","DOI":"10.1002\/cpt.1296","article-title":"Abemaciclib Inhibits Renal Tubular Secretion Without Changing Glomerular Filtration Rate","volume":"105","author":"Chappell","year":"2019","journal-title":"Clin Pharma and Therapeutics"},{"key":"2025082801231923000_18.5.e261725.9","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-1755.2002.00433.x"},{"key":"2025082801231923000_18.5.e261725.10","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.00740110"},{"key":"2025082801231923000_18.5.e261725.11","doi-asserted-by":"crossref","unstructured":"Ly E , Howard FM , Chen N , et al . Evaluation of cyclin-dependent kinase 4\/6 inhibitor-induced serum creatinine elevations in patients with hormone receptor positive breast cancer. J Oncol Pharm Pract 2024;10781552241305417. doi:10.1177\/10781552241305417","DOI":"10.1177\/10781552241305417"},{"key":"2025082801231923000_18.5.e261725.12","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1159\/000525029","article-title":"Onconephrology: Update in Anticancer Drug-Related Nephrotoxicity","volume":"147","author":"Garc\u00eda-Carro","year":"2023","journal-title":"Nephron"},{"key":"2025082801231923000_18.5.e261725.13","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-65-6-1287"},{"key":"2025082801231923000_18.5.e261725.14","article-title":"Challenges of Renal Function Assessment in Breast Cancer Patients Treated With Abemaciclib: A Case Report","volume":"16","author":"Ferreira","year":"2024","journal-title":"Cureus"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2024-261725","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T08:23:28Z","timestamp":1756369408000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2024-261725"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5]]},"references-count":14,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,5,30]]},"published-print":{"date-parts":[[2025,5]]}},"alternative-id":["10.1136\/bcr-2024-261725"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2024-261725","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5]]}}}