Mineralocorticoid excess: hypokalemia, hypertension, edema.

Diarrhea-driven prerenal AKI.

Severe hyperglycemia (on-target) → osmotic diuresis and prerenal AKI risk.

Newly recognized acute interstitial nephritis in lung cancer — flagged by clinicians.

Predominantly hepatobiliary elimination; renal clearance minor, kidney risk mainly tumor lysis in AML; reduce dose in organ impairment.

Differentiation syndrome; QT prolongation.

Hypertension and pancreatitis; allosteric BCR-ABL inhibitor.

Edema, intracranial bleeding and cognitive effects.

Renal tubular acidosis and rare AKI.

Tumor lysis-mediated AKI is the principal risk; TMA is rare.

Hepatically cleared, kidney-neutral, no renal dose adjustment; only rare idiosyncratic interstitial nephritis.

Renally excreted (~2/3 in urine); half-life rises exponentially below CrCl 25-35 — exposure/clearance issue amplifying pulmonary toxicity, not a direct nephrotoxin.

Tubulointerstitial AKI; vemurafenib strongest.

Tumor lysis in lymphoma.

2023 breast-cancer AKT inhibitor; AKI with diarrhea/hyperglycemia.

Kidney-sparing; GFR-dosed by the Calvert formula.

Lipophilic oral 5-FU prodrug (Japan); class-level renal risk; hallmark toxicity is leukoencephalopathy not nephropathy.

Trial-stage RCC HIF-2α inhibitor; renal profile being defined.

Intraperitoneal; cytokine-release- and ascites/paracentesis-driven prerenal AKI; withdrawn (EU) 2017.

TRPM6 magnesium wasting.

Minimal direct nephrotoxicity; rare drug-associated SIADH/hyponatremia is the kidney-relevant signal.

CRS-driven AKI; delayed neurotoxicity.

Proximal tubular ATN + magnesium wasting; the archetype.

Tumor lysis; high-dose nephrotoxicity.

Transient infusion-related hypertension and hyperglycemia.

Reversible creatinine rise and renal cysts.

Tumor lysis in leukemia; high-dose toxicity.

Renal risk indirect via tumor lysis in chemosensitive pediatric tumors; hepatic veno-occlusive disease is the signature organ toxicity.

Tumor lysis; usable in renal impairment.

Not nephrotoxic; exposure rises in severe renal impairment, so consider dose adaptation.

Tumor lysis in MDS/AML.

Severe hypocalcemia in low GFR; not directly nephrotoxic.

5'-DFUR prodrug; class-level TMA risk plus a real renal-clearance component warranting caution in renal impairment.

Kidney-neutral antibody; unchanged PK in severe impairment and dialysis; no renal dose adjustment.

Differentiation syndrome and tumor lysis.

Emerging AKI and electrolyte signals in urothelial cancer.

Hypertension; rare electrolyte effects.

CRS and tumor lysis — emerging.

Hyperphosphatemia is an on-target class effect.

Tumor lysis; renally cleared.

Tumor lysis; accumulates in renal impairment.

Class delayed cumulative tubulointerstitial/ATN; usually mild; acute signal often really cisplatin.

Hyperphosphatemia, class effect.

Tumor lysis and veno-occlusive disease.

Differentiation syndrome, tumor lysis and PRES in AML.

QT prolongation and muscle spasms; AML.

CRS and tumor lysis — emerging.

Tumor lysis in myeloproliferative disease.

Lower renal risk than zoledronate.

Yttrium-90 radioimmunotherapy; tumor lysis with bulky lymphoma.

Tumor lysis in acute leukemia.

CRS-driven AKI and tumor lysis in myeloma.

Chloroacetaldehyde → Fanconi syndrome.

Fluid retention; rare Fanconi and AKI.

2024 MDS agent; tumor lysis risk.

Hyperphosphatemia — on-target FGFR class effect; nephrocalcinosis risk.

Tumor lysis and VOD in ALL.

Tumor lysis in myeloma.

Differentiation syndrome → AKI; tumor lysis.

Kidney-neutral (CLARINET: diarrhea dominant); increased exposure in renal impairment.

2024 EGFR TKI; hyponatremia like osimertinib.

Metabolic syndrome; indirect renal risk.

2024 cellular therapy; high-dose IL-2 conditioning → capillary leak AKI.

Capillary-leak-type edema, effusions and AKI.

Edema and metabolic effects.

Rhabdomyolysis risk in small-cell lung cancer.

PSMA-targeted radioligand for prostate cancer; renal radiation exposure and xerostomia.

Tumor lysis in bulky lymphoma is the main renal hazard; modern topical gel has no detectable systemic absorption.

SIADH in high-dose myeloma conditioning; renally cleared.

Delivers melphalan intracellularly; BRIDGE supports a reduced 30 mg dose in moderate renal impairment.

Tumor lysis, edema and QT in AML/mastocytosis.

2025 NF1 MEK inhibitor; creatinine rise and edema.

Ocular toxicity dominates; renal involvement indirect/case-level (GI volume loss).

Indirect: hypoadrenalism drives hyponatremia/prerenal; cisplatin nephrotoxicity in EDP-M.

Tumor lysis; low direct renal toxicity.

Diarrhea-driven prerenal AKI; QT prolongation.

Tumor lysis and rare AKI; cutaneous T-cell lymphoma.

2023 myelofibrosis JAK inhibitor.

CRS and tumor lysis in lymphoma.

Severe hypomagnesemia, class effect.

Second-gen platinum with reduced renal toxicity vs cisplatin.

Tumor lysis in T-ALL.

Severe diarrhea → prerenal AKI; loperamide prophylaxis.

Water-soluble nitrosourea; renal risk inferred at class level; cumulative delayed tubulointerstitial injury; DLT is myelosuppression.

2023 desmoid-tumor agent; phosphate/electrolyte disturbance.

High tumor-lysis risk in CLL.

Kidney-neutral/possibly renoprotective; renally cleared, caution in severe CKD/dialysis.

Differentiation syndrome and tumor lysis in AML.

Hyponatremia and occasional AKI.

Generally renally well tolerated.

Cumulative tubular toxicity, RTA and nephrogenic DI.

Hyperphosphatemia; nephrocalcinosis risk.

Renally cleared; dose-related acute kidney injury.

2023 BTK inhibitor; tumor lysis risk.

Cumulative tubular ATN; hypocalcemia is an on-target antiresorptive effect.

Tumor lysis; emerging renal data.

Tumor lysis; usable in renal impairment.

2023 AML FLT3 inhibitor; tumor lysis and QT.

2023 ROS1 inhibitor; creatinine rise via secretion block.

2024 leukemia agent; differentiation syndrome and tumor lysis.

Creatinine rise; QT prolongation.

Tumor lysis with bulky disease; treats some GN.

Transporter-mediated creatinine rise.

Tumor lysis in myelofibrosis; renally adjusted.

Renally excreted; dominant toxicity is reversible myelosuppression; caution in renal impairment.

Hyponatremia is common and dose-limiting.

Creatinine rise in neurofibromatosis.

Classic proximal tubular toxin → Fanconi and dose-limiting AKI.

Renally excreted, so caution in renal impairment; myelosuppression is the dominant toxicity.

2025 EGFR exon20 TKI; electrolyte effects emerging.

Tumor lysis and infusion reactions in lymphoma.

Hypercalcemia flare; rare hyponatremia.

Tumor lysis; generally low direct renal toxicity.

Oral tegafur+uracil; rare fluoropyrimidine-class TMA/HUS (often with mitomycin C), otherwise kidney-sparing.

Occasional SIADH; generally renally well tolerated.

Highly protein-bound, low renal clearance (~10-25% urinary); renal relevance is PK/exposure not direct injury; not dialyzable.

Tumor lysis and bradycardia.

2024 pediatric glioma RAF inhibitor; creatinine rise.

Rhabdomyolysis → pigment nephropathy; hepatotoxicity.

Emerging AKI/proteinuria reports — under-published.

Tipiracil is renally cleared; reduced GFR raises exposure and early severe neutropenia; dose-reduce in renal impairment.

Major tumor lysis syndrome risk on ramp-up.

SIADH and rare Raynaud/vascular events.

SIADH → hyponatremia.

Used because of renal impairment (cisplatin-unfit urothelial); CrCl-based dose bands; watch SIADH/hyponatremia.

SIADH reports.

Muscle spasms; hyponatremia reported.

2024 biliary-tract HER2 bispecific; renal data emerging.

Trial-stage AML menin inhibitor; differentiation syndrome / TLS predicted.