BRAF / MEK inhibitors (vemurafenib · dabrafenib · trametinib)
BRAF/MEK inhibitor
Tubulointerstitial AKI; vemurafenib strongest.
Tafinlar · DAB
BRAF inhibitor · approved 2013 · 9 citations · FAERS AKI reporting ROR 1.50 (95% CI 1.32–1.72, 228 AKI reports)
Describes how this page is sourced, not how dangerous the drug is. Thinly sourced means fewer of the sourcing signals are met — not that the agent is kidney-safe. A rule-based summary, not a formal certainty appraisal.
The gentler BRAF inhibitor — mostly pyrexia-driven, reversible AKI, with granulomatous interstitial nephritis as its rare histologic signature.
Signature lesion
AKI is relatively common on dabrafenib-based therapy but usually mild and reversible. In the largest cohort, 42/199 (21%) of patients on dabrafenib/trametinib developed AKI within 12 months, and roughly 24% of those episodes occurred during the drug-induced febrile (pyrexia) syndrome (Seethapathy 2022). Pharmacovigilance places dabrafenib well below vemurafenib: FAERS acute-kidney-injury reporting-odds-ratio approximately 1.35 (95% CI 1.15–1.60) for dabrafenib versus approximately 3.28 for vemurafenib (Sanagawa 2021). Biopsy-proven granulomatous/acute interstitial nephritis and clinically significant electrolyte disorders (hyponatremia, hypokalemia, hypophosphatemia) are each individually rare — documented mainly in case reports and small FAERS counts. Registrational trials did not flag renal toxicity; the signal emerged post-marketing.Source: Seethapathy et al., Nephrol Dial Transplant 2022 (PMID 33355659): 42/199 (21%) of dabrafenib/trametinib patients developed AKI within 12 months in a single-center retrospective cohort, with ~24% of AKI episodes occurring during the drug-induced pyrexia/febrile syndrome. This is all-cause AKI on combination therapy and largely mild/reversible; drug-specific granulomatous interstitial nephritis is far rarer.
AKI most often coincides with the dabrafenib/trametinib febrile syndrome (fever, chills, GI symptoms, transaminitis), clustering in the first weeks to months; a single biopsy-proven granulomatous acute interstitial nephritis case is documented. The cited cohort defined AKI within a 12-month window, so it does not establish later onset.
Distilled from: “Forty-two patients (21%) experienced AKI within 12 months; 10 patients (5% of the total cohort, 24% of AKI patients) experienced AKI occurring during a dabrafenib/trametinib-induced febrile syndrome characterized by fever, chills, gastrointestinal symptoms and elevated liver enzymes. One patient had biopsy-proven granulomatous acute interstitial nephritis that resolved with corticosteroids.” · PMID 33355659 (opens PubMed in a new tab)
This agent's kidney lesions ordered by prominence — the #1 signature lesion first, then secondary and rare patterns. Cited incidence is shown where a citable figure exists; otherwise the tier stands qualitatively.
Immune-mediated inflammation of the renal interstitium — the signature kidney injury of checkpoint inhibitors.
Renal hypoperfusion from capillary leak and cytokine storm — IL-2 and CAR-T cytokine release syndrome.
Renal electrolyte derangement — magnesium/potassium/calcium wasting (cisplatin, anti-EGFR antibodies) or retention (FGFR-inhibitor hyperphosphatemia, tumor-lysis hyperkalemia/hyperphosphatemia).
Inappropriate water retention at the collecting duct — high-dose cyclophosphamide.
Direct death of tubular epithelial cells — the dose-limiting lesion of the platinums and zoledronate.
Tap a signature to trace where it strikes the nephron.
Acute Interstitial Nephritis
Immune-mediated inflammation of the renal interstitium — the signature kidney injury of checkpoint inhibitors.
Selective ATP-competitive inhibitor of mutant BRAF V600E/K kinase that shuts down constitutive RAF–MEK–ERK (MAPK) signaling driving BRAF-mutant tumor proliferation. Almost always paired with the MEK inhibitor trametinib to deepen and prolong response and blunt paradoxical MAPK reactivation (fewer cutaneous squamous lesions than single-agent BRAF inhibition).
Class-level context for the major non-renal toxicities of the BRAF inhibitor class.
Dermatologic
Rash, HFS, SJS/TEN, vitiligo
Cardiac
Cardiomyopathy, QT, ischemia, myocarditis
Ophthalmic
Keratopathy, uveitis, retinopathy
Vascular
Hypertension, VTE/ATE, bleeding, aneurysm
8 primary references — trials, cohorts, mechanism, and reviews. Single-patient case reports are listed separately below, graded by strength. Citation metadata via PubMed / NLM.
Primary (non–case-report) references per year — a proxy for how actively the agent's renal literature is accruing. Recent years are highlighted. Reflects curation depth, not a systematic bibliometric count.
Single-patient and small-series reports, graded by evidentiary strength — A Strong (biopsy-proven plus a series and/or positive rechallenge), B Moderate, and C Limited (a single clinically-diagnosed case). Strongest first. Grades are inferred automatically from each report's abstract and journal — a heuristic ranking aid, not a formal quality appraisal.
Everything below is FAERS — adverse events someone chose to report, about 20,946 of them for this agent. Nobody counts the patients who were fine, so none of these numbers is an incidence, a risk, or a rate: they describe what gets reported, shaped by a drug's fame, its indication, and who was watching. How these numbers work.
Only significant signals appear (95% CI lower bound above 1) — a phenotype missing here was tested and did not reach significance, except Prerenal / Hemodynamic AKI, Pseudo-AKI, Renal Cysts, Chronic Interstitial Nephropathy — outside the clinician-reviewed MedDRA term map, never queried — and ATN and AIN, queried but biopsy-bound: real cases are filed as generic “acute kidney injury”, so their absence is not a negative. As of 2026-10-01.
What reporting says about this profile's documented lesions
Reported with a death outcome
4,394 of 20,946 reports
Reported with hospitalization
5,837 of 20,946 reports
Reports per year
Yearly FAERS report volume · most recent year is partial.
Bars rank systems by summed reaction-term mentions (a report counts once per term it names) — an ordinal “more vs less reported” cue, not a tally of distinct reports. Renal & urinary first. As of 2026-10-01.
Each recommendation below is this atlas's faithful summary of the source, not a quotation from it — follow the PubMed link for the wording the society published. Summaries may be superseded; consult the current full text and individualize to the patient.
General onco-nephrology references
Where Dabrafenib sits in nephrotoxicity space — each dot is an anti-cancer agent, positioned so neighbors share a kidney-injury phenotype. Its 6 closest are filled and lead to a numbered marker, matching the numbered cards below.
BRAF/MEK inhibitor
Tubulointerstitial AKI; vemurafenib strongest.
Cotellic · MEK inhibitor
Real-world AKI signal with BRAF partners.
Braftovi · BRAF inhibitor
Class tubular signal; usually mild.
Avmapki (co-packaged with defactinib as Avmapki Fakzynja) · RAF/MEK inhibitor
RAF/MEK clamp; CK elevation/rhabdomyolysis and tubular electrolyte wasting.
Zynyz · PD-1 immune checkpoint inhibitor
PD-1 blockade — kidney injury is immune-mediated interstitial nephritis, not direct tubular toxicity.
Zegfrovy · EGFR exon20 TKI
2025 EGFR exon20 TKI; renal magnesium wasting (SIADH-pattern hyponatremia possible).
Nearest agents by kidney-injury phenotype (shared injuries, nephron target, severity, class) — a similarity approximation, not a claim of shared drug identity or mechanism.
Same-class agents ordered by their documented kidney-injury profile — atlas severity, an acute-kidney-injury FAERS signal, and how many injury types each is documented to cause. Agents nearer the top carry the lighter documented renal profile.
A comparison of documented kidney-injury data within one drug class — not a substitution recommendation. Efficacy, indication, and non-renal toxicity differ between these agents and are out of scope here. Educational only, not medical advice.
The leading contributors to Dabrafenib’s clinical kidney literature on PubMed, ranked by a blend of publication volume and citation impact — filtered toward clinical work via the PubMed Humans heading and clinical publication types (trials, cohorts, case reports, guidelines, reviews). Names link to that author’s work on Dabrafenib; the PMIDs beside each name are up to three of their most recent papers on it, not the full count.
Ranked by a 50/50 blend of publication volume and a position-weighted, capped Relative Citation Ratio (NIH iCite) on this agent’s renal literature; the citation count shown is the raw total, not the ranking score — counted over the 22 clinical records among all 27 PubMed matches, so counts are within-sample — bibliometric context, not an endorsement or a measure of clinical authority.