Nintedanib-Associated Glomerular Endothelial Injury With Secondary Collapsing Focal Segmental Glomerulosclerosis: Potential Role of Sodium-Glucose Cotransporter 2 Inhibition.
Yoshitaka Furuto, Hirotsugu Hashimoto, Daiki Yoshino et al.
✦ AI-curated · Sources linked
Case in brief
A 69-year-old man with idiopathic pulmonary fibrosis and chronic kidney disease developed persistent nephrotic syndrome and renal dysfunction 16 months after starting nintedanib. Kidney biopsy revealed glomerular endothelial injury and secondary collapsing focal segmental glomerulosclerosis. Despite stopping nintedanib and intensifying supportive therapy, nephrotic-range proteinuria persisted until the initiation of dapagliflozin, which led to a gradual reduction in proteinuria and partial remission.
What made this case unusual
This case highlights nintedanib-associated glomerular endothelial injury leading to secondary collapsing focal segmental glomerulosclerosis, a rare complication not commonly reported.
Diagnostic / clinical pearl
Clinicians should be aware that nintedanib can cause glomerular endothelial injury, potentially leading to nephrotic syndrome and secondary collapsing focal segmental glomerulosclerosis.
Why it matters
The case suggests that sodium-glucose cotransporter 2 inhibitors may offer a therapeutic option for managing proteinuria in patients with nintedanib-associated kidney injury, warranting further investigation.