title: Renal injury following intravitreal anti-VEGF administration in diabetic patients with proliferative diabetic retinopathy and chronic kidney disease--a possible side effect?
abstract: The use of intravitreal injections of anti-Vascular Endothelial Growth Factor (anti-VEGF) has been used for a broad spectrum of ocular pathologic entities. Although the dose of anti-VEGF agents used for treating eye disease is minute compared with that used intravenously, intraocular administration can lead to systemic absorption and reduce serum VEGF levels. Several systemic side effects, such as hypertension and cardiovascular complications have been rarely reported in the literature. Renal complications of intravenous administration of anti-VEGF, are well known and include a variety of renal pathological damage which can induce proteinuria and hypertension. We describe herein, 2 cases of diabetic patients with preexisting kidney disease who presented severe reduction of their renal function after intraocular administration of anti-VEGF. Although a cause -effect correlation cannot be established unless further studies are performed, we believe that pretreatment counseling should include a discussion outlining the possible risk of aggravating of the renal function in patients with kidney disease. Close cooperation with the patient's nephrologist and close monitoring of the patient may be required, in such cases, in order to monitor the renal function before and after the intravitreal administration of anti-VEGF.
authors: Ilias
authors: I
authors: Georgalas
authors: Dimitris
authors: D
authors: Papaconstantinou
authors: Kostas
authors: K
authors: Papadopoulos
authors: Dionisis
authors: D
authors: Pagoulatos
authors: Dimitris
authors: D
authors: Karagiannis
authors: Department of Ophthalmology, University of Athens, Greece. igeorgalas@yahoo.com.
authors: Chryssanthi
authors: C
authors: Koutsandrea
mesh_terms: D000368:Aged; D003928:Diabetic Nephropathies / Q000188:drug therapy*; D003930:Diabetic Retinopathy / Q000188:drug therapy*; D005260:Female; D006801:Humans; D058449:Intravitreal Injections; D007668:Kidney / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000150:complications*; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors*
chemical_list: D042461:Vascular Endothelial Growth Factor A