§Class effects

Kidney toxicity by drug family

Nephrotoxicity often runs in classes, not just molecules. This is the class × injury matrix made interactive: pick a family to read its whole-class renal story — the signature lesions, the citation-grounded synthesis, and the agents that carry it. Kinase inhibitors are subset by target beneath the TKI umbrella. 14 of 19 class groups carry a dedicated class-effect synthesis.

Count of agents per drug-class family (rows) whose signature kidney injury is each lesion (columns). Select an injury column to filter, or a class family to read its class-effect synthesis.
Class family

Each cell counts the agents in a class family whose signature lesion is that injury. Click a family to read its class-effect synthesis; click an injury column to narrow the member list to that lesion.

Kinase inhibitors (TKIs) ›

ALK / ROS1 / MET / TRK inhibitors

12 agents · 12 deep-profiled

HypertensionGlomerular Injury / ProteinuriaPseudo-AKIElectrolyte DisturbanceThrombotic Microangiopathy

Class-wide synthesis · Kinase inhibitors (TKIs)

VEGFR-targeting TKIs (sunitinib, sorafenib, pazopanib, cabozantinib) share the antiangiogenic class signature of hypertension and proteinuria, with glomerular lesions (FSGS-like, minimal change) and occasional TMA; cabozantinib carries among the highest hypertension risk (all-grade RR ~5.5). Distinct from true nephrotoxicity, many targeted agents (TKIs, CDK4/6 inhibitors, MET inhibitors) inhibit the renal cationic transporters OCT2 and MATE1/2-K, blocking tubular creatinine secretion and producing a reversible, asymptomatic serum-creatinine rise (pseudo-AKI) with preserved measured GFR. Electrolyte disturbances and, with certain agents, benign renal cysts also occur. The management headline is to confirm true injury with cystatin-C or measured GFR before dose-reducing for an isolated creatinine bump, while genuinely controlling hypertension and monitoring proteinuria.

Member agents (12)

Alectinib Brigatinib Capmatinib Ceritinib Crizotinib Ensartinib Entrectinib Larotrectinib Lorlatinib Repotrectinib Taletrectinib Tepotinib

Class-effect evidence (5)

See the full atlas

Class-effect syntheses summarize the strongest available evidence for a whole family and, where a newer agent's renal signal is extrapolated from its class rather than established directly, that is noted on the agent's page. Educational content — not medical advice.