§Insights

The data behind the atlas

Ten ways of looking at anti-cancer nephrotoxicity — the same citation-grounded catalog, re-seen as similarity space, as a growing evidence base, as pharmacovigilance signal, and as renal anatomy. Every figure is drawn from the profiled data and needs no login.

Every anti-cancer agent placed so that nearness means a similar kidney-injury phenotype — computed from its injury signature, the nephron segments it strikes, severity, and drug class. Neighborhoods emerge on their own: platinum tubular injury, anti-VEGF glomerular disease, the checkpoint-inhibitor interstitial cluster. Dot size scales with FAERS reporting volume. Filter by injury; tap a profiled agent to open it.

Cisplatin · Acute Tubular Necrosis · Platinum agentsCarboplatin · Acute Tubular Necrosis · Platinum agentsOxaliplatin · Thrombotic Microangiopathy · Platinum agentsNedaplatin · Acute Tubular Necrosis · Platinum agentsIfosfamide · Fanconi Syndrome · Alkylating agentsCyclophosphamide · SIADH / Hyponatremia · Alkylating agentsStreptozocin · Fanconi Syndrome · Alkylating agentsCarmustine (BCNU) · Chronic Interstitial Nephropathy · Alkylating agentsLomustine (CCNU) · Chronic Interstitial Nephropathy · Alkylating agentsBendamustine · Crystal / Obstructive Nephropathy · Alkylating agentsMelphalan · SIADH / Hyponatremia · Alkylating agentsBusulfan · Thrombotic Microangiopathy · Alkylating agentsTemozolomide · SIADH / Hyponatremia · Alkylating agentsDacarbazine · Prerenal / Hemodynamic AKI · Alkylating agentsThiotepa · Hemorrhagic Cystitis · Alkylating agentsMethotrexate (high-dose) · Crystal / Obstructive Nephropathy · AntimetabolitesPemetrexed · Acute Tubular Necrosis · AntimetabolitesGemcitabine · Thrombotic Microangiopathy · AntimetabolitesPralatrexate · Crystal / Obstructive Nephropathy · Antimetabolites5-Fluorouracil · Thrombotic Microangiopathy · AntimetabolitesCapecitabine · Prerenal / Hemodynamic AKI · AntimetabolitesCytarabine · Prerenal / Hemodynamic AKI · AntimetabolitesFludarabine · Crystal / Obstructive Nephropathy · AntimetabolitesClofarabine · Prerenal / Hemodynamic AKI · AntimetabolitesAzacitidine · Acute Tubular Necrosis · Other targeted agentsDecitabine · Prerenal / Hemodynamic AKI · Other targeted agentsHydroxyurea · Prerenal / Hemodynamic AKI · Other targeted agentsNelarabine · Prerenal / Hemodynamic AKI · AntimetabolitesMitomycin C · Thrombotic Microangiopathy · Antitumor antibioticsDoxorubicin · Glomerular Injury / Proteinuria · Antitumor antibioticsPlicamycin (mithramycin) · Acute Tubular Necrosis · Antitumor antibioticsBevacizumab · Glomerular Injury / Proteinuria · Anti-angiogenic (VEGF)Ramucirumab · Hypertension · Anti-angiogenic (VEGF)Ziv-aflibercept · Hypertension · Anti-angiogenic (VEGF)VEGFR TKIs (sunitinib · sorafenib · pazopanib · axitinib) · Hypertension · Anti-angiogenic (VEGF)Lenvatinib · Hypertension · Anti-angiogenic (VEGF)Cabozantinib · Hypertension · Anti-angiogenic (VEGF)Regorafenib · Hypertension · Anti-angiogenic (VEGF)Vandetanib · Hypertension · Anti-angiogenic (VEGF)Tivozanib · Hypertension · Anti-angiogenic (VEGF)Nintedanib · Hypertension · Anti-angiogenic (VEGF)mTOR inhibitors (everolimus · temsirolimus) · Glomerular Injury / Proteinuria · Other targeted agentsSirolimus · Glomerular Injury / Proteinuria · Other targeted agentsCetuximab & Panitumumab · Electrolyte Disturbance · Kinase inhibitors (TKIs)Necitumumab · Electrolyte Disturbance · Kinase inhibitors (TKIs)Osimertinib · SIADH / Hyponatremia · Kinase inhibitors (TKIs)Erlotinib · Glomerular Injury / Proteinuria · Kinase inhibitors (TKIs)Gefitinib · Glomerular Injury / Proteinuria · Kinase inhibitors (TKIs)Afatinib · Prerenal / Hemodynamic AKI · Kinase inhibitors (TKIs)Checkpoint inhibitors (pembrolizumab · nivolumab · ipilimumab) · Acute Interstitial Nephritis · Checkpoint inhibitorsAtezolizumab · Acute Interstitial Nephritis · Checkpoint inhibitorsDurvalumab · Acute Interstitial Nephritis · Checkpoint inhibitorsAvelumab · Acute Interstitial Nephritis · Checkpoint inhibitorsCemiplimab · Acute Interstitial Nephritis · Checkpoint inhibitorsDostarlimab · Acute Interstitial Nephritis · Checkpoint inhibitorsCAR-T cell therapy · Prerenal / Hemodynamic AKI · CAR-T cell therapyBlinatumomab · Prerenal / Hemodynamic AKI · Bispecifics / T-cell engagersTeclistamab · Prerenal / Hemodynamic AKI · Bispecifics / T-cell engagersTalquetamab · Prerenal / Hemodynamic AKI · Bispecifics / T-cell engagersElranatamab · Prerenal / Hemodynamic AKI · Bispecifics / T-cell engagersMosunetuzumab · Prerenal / Hemodynamic AKI · Bispecifics / T-cell engagersEpcoritamab · Prerenal / Hemodynamic AKI · Bispecifics / T-cell engagersGlofitamab · Prerenal / Hemodynamic AKI · Bispecifics / T-cell engagersEnfortumab vedotin · Acute Tubular Necrosis · Antibody-drug conjugatesSacituzumab govitecan · Prerenal / Hemodynamic AKI · Antibody-drug conjugatesTrastuzumab deruxtecan · Acute Tubular Necrosis · Antibody-drug conjugatesTrastuzumab emtansine (T-DM1) · Thrombotic Microangiopathy · Antibody-drug conjugatesBrentuximab vedotin · Electrolyte Disturbance · Antibody-drug conjugatesPolatuzumab vedotin · Prerenal / Hemodynamic AKI · Antibody-drug conjugatesBelantamab mafodotin · Glomerular Injury / Proteinuria · Antibody-drug conjugatesMirvetuximab soravtansine · Prerenal / Hemodynamic AKI · Antibody-drug conjugatesTisotumab vedotin · Prerenal / Hemodynamic AKI · Antibody-drug conjugatesTebentafusp · Prerenal / Hemodynamic AKI · Bispecifics / T-cell engagersZolbetuximab · Prerenal / Hemodynamic AKI · Monoclonal antibodies (other)Elacestrant · Prerenal / Hemodynamic AKI · Hormonal / endocrineRelatlimab · Acute Interstitial Nephritis · Checkpoint inhibitorsGemtuzumab ozogamicin · Prerenal / Hemodynamic AKI · Antibody-drug conjugatesInotuzumab ozogamicin · Prerenal / Hemodynamic AKI · Antibody-drug conjugatesCarfilzomib · Thrombotic Microangiopathy · Other targeted agentsBortezomib · Thrombotic Microangiopathy · Other targeted agentsIxazomib · Thrombotic Microangiopathy · Other targeted agentsLenalidomide · Acute Tubular Necrosis · Other targeted agentsPomalidomide · Prerenal / Hemodynamic AKI · Other targeted agentsThalidomide · Prerenal / Hemodynamic AKI · Other targeted agentsImatinib · Electrolyte Disturbance · Kinase inhibitors (TKIs)Dasatinib · Glomerular Injury / Proteinuria · Kinase inhibitors (TKIs)Nilotinib · Prerenal / Hemodynamic AKI · Kinase inhibitors (TKIs)Ponatinib · Hypertension · Kinase inhibitors (TKIs)Bosutinib · Pseudo-AKI · Kinase inhibitors (TKIs)Crizotinib · Renal Cysts · Kinase inhibitors (TKIs)Alectinib · Pseudo-AKI · Kinase inhibitors (TKIs)Brigatinib · Pseudo-AKI · Kinase inhibitors (TKIs)Lorlatinib · Pseudo-AKI · Kinase inhibitors (TKIs)Ceritinib · Prerenal / Hemodynamic AKI · Kinase inhibitors (TKIs)Olaparib · Pseudo-AKI · Other targeted agentsNiraparib · Hypertension · Other targeted agentsRucaparib · Pseudo-AKI · Other targeted agentsTalazoparib · Pseudo-AKI · Other targeted agentsBRAF / MEK inhibitors (vemurafenib · dabrafenib · trametinib) · Acute Tubular Necrosis · Kinase inhibitors (TKIs)Encorafenib · Acute Tubular Necrosis · Kinase inhibitors (TKIs)Cobimetinib · Acute Tubular Necrosis · Kinase inhibitors (TKIs)Binimetinib · Prerenal / Hemodynamic AKI · Kinase inhibitors (TKIs)Selumetinib · Prerenal / Hemodynamic AKI · Kinase inhibitors (TKIs)Erdafitinib · Electrolyte Disturbance · Kinase inhibitors (TKIs)Pemigatinib · Electrolyte Disturbance · Kinase inhibitors (TKIs)Futibatinib · Electrolyte Disturbance · Kinase inhibitors (TKIs)Selpercatinib · Hypertension · Kinase inhibitors (TKIs)Pralsetinib · Hypertension · Kinase inhibitors (TKIs)Capmatinib · Pseudo-AKI · Kinase inhibitors (TKIs)Tepotinib · Pseudo-AKI · Kinase inhibitors (TKIs)Ivosidenib · Prerenal / Hemodynamic AKI · Other targeted agentsEnasidenib · Prerenal / Hemodynamic AKI · Other targeted agentsSotorasib · Prerenal / Hemodynamic AKI · Kinase inhibitors (TKIs)Adagrasib · Prerenal / Hemodynamic AKI · Kinase inhibitors (TKIs)Belzutifan · Prerenal / Hemodynamic AKI · Other targeted agentsIbrutinib · Hypertension · Kinase inhibitors (TKIs)Acalabrutinib · Hypertension · Kinase inhibitors (TKIs)Zanubrutinib · Prerenal / Hemodynamic AKI · Kinase inhibitors (TKIs)Venetoclax · Crystal / Obstructive Nephropathy · Other targeted agentsTretinoin (ATRA) · Prerenal / Hemodynamic AKI · Kinase inhibitors (TKIs)Arsenic trioxide · Prerenal / Hemodynamic AKI · Other targeted agentsRituximab · Crystal / Obstructive Nephropathy · Monoclonal antibodies (other)Obinutuzumab · Crystal / Obstructive Nephropathy · Monoclonal antibodies (other)Daratumumab · Prerenal / Hemodynamic AKI · Monoclonal antibodies (other)Isatuximab · Prerenal / Hemodynamic AKI · Monoclonal antibodies (other)Abemaciclib · Pseudo-AKI · Kinase inhibitors (TKIs)Palbociclib · Pseudo-AKI · Kinase inhibitors (TKIs)Ribociclib · Pseudo-AKI · Kinase inhibitors (TKIs)Tagraxofusp · Prerenal / Hemodynamic AKI · Other targeted agentsIrinotecan · Prerenal / Hemodynamic AKI · Other targeted agentsTopotecan · Prerenal / Hemodynamic AKI · Other targeted agentsEtoposide · Prerenal / Hemodynamic AKI · Other targeted agentsVincristine · SIADH / Hyponatremia · Kinase inhibitors (TKIs)Vinblastine · SIADH / Hyponatremia · Kinase inhibitors (TKIs)Vinorelbine · SIADH / Hyponatremia · Kinase inhibitors (TKIs)Paclitaxel · Prerenal / Hemodynamic AKI · Other targeted agentsDocetaxel · Prerenal / Hemodynamic AKI · Other targeted agentsCabazitaxel · Prerenal / Hemodynamic AKI · Other targeted agentsEribulin · Prerenal / Hemodynamic AKI · Other targeted agentsAsparaginase · Prerenal / Hemodynamic AKI · Cytokines & enzymesInterferon-α · Glomerular Injury / Proteinuria · Cytokines & enzymesInterleukin-2 (high-dose) · Prerenal / Hemodynamic AKI · Cytokines & enzymesZoledronic acid · Acute Tubular Necrosis · Bisphosphonates & bonePamidronate · Glomerular Injury / Proteinuria · Bisphosphonates & boneDenosumab · Electrolyte Disturbance · Bisphosphonates & boneIbandronate · Acute Tubular Necrosis · Bisphosphonates & boneAbiraterone · Electrolyte Disturbance · Hormonal / endocrineEnzalutamide · Hypertension · Hormonal / endocrineTamoxifen · SIADH / Hyponatremia · Other targeted agentsLeuprolide · Hypertension · Hormonal / endocrineAmivantamab · Acute Interstitial Nephritis · Bispecifics / T-cell engagersDatopotamab deruxtecan (Dato-DXd) · Acute Tubular Necrosis · Antibody-drug conjugatesTarlatamab · Prerenal / Hemodynamic AKI · Bispecifics / T-cell engagersRevumenib · Prerenal / Hemodynamic AKI · Kinase inhibitors (TKIs)Fruquintinib · Hypertension · Anti-angiogenic (VEGF)Pirtobrutinib · Crystal / Obstructive Nephropathy · Kinase inhibitors (TKIs)Capivasertib · Prerenal / Hemodynamic AKI · Kinase inhibitors (TKIs)Nirogacestat · Electrolyte Disturbance · Kinase inhibitors (TKIs)Lazertinib · SIADH / Hyponatremia · Kinase inhibitors (TKIs)Repotrectinib · Pseudo-AKI · Kinase inhibitors (TKIs)Zanidatamab · Prerenal / Hemodynamic AKI · Bispecifics / T-cell engagersLifileucel · Prerenal / Hemodynamic AKI · Other targeted agentsTovorafenib · Prerenal / Hemodynamic AKI · Other targeted agentsImetelstat · Prerenal / Hemodynamic AKI · Other targeted agentsMirdametinib · Prerenal / Hemodynamic AKI · Kinase inhibitors (TKIs)Sunvozertinib · SIADH / Hyponatremia · Kinase inhibitors (TKIs)Tucatinib · Pseudo-AKI · Kinase inhibitors (TKIs)Ruxolitinib · Prerenal / Hemodynamic AKI · Other targeted agentsMomelotinib · Pseudo-AKI · Other targeted agentsEntrectinib · Pseudo-AKI · Kinase inhibitors (TKIs)Quizartinib · Prerenal / Hemodynamic AKI · Kinase inhibitors (TKIs)Ziftomenib · Prerenal / Hemodynamic AKI · Kinase inhibitors (TKIs)Casdatifan · Prerenal / Hemodynamic AKI · Other targeted agentsZongertinib · Pseudo-AKI · Kinase inhibitors (TKIs)Lutetium-177 Dotatate · Chronic Interstitial Nephropathy · RadiopharmaceuticalsLutetium-177 PSMA-617 (vipivotide) · Chronic Interstitial Nephropathy · RadiopharmaceuticalsIbritumomab tiuxetan · Prerenal / Hemodynamic AKI · Other targeted agentsRadium-223 dichloride · Prerenal / Hemodynamic AKI · RadiopharmaceuticalsTrabectedin · Acute Tubular Necrosis · Alkylating agentsLurbinectedin · Acute Tubular Necrosis · Alkylating agentsMoxetumomab pasudotox · Thrombotic Microangiopathy · Other targeted agentsDenileukin diftitox · Prerenal / Hemodynamic AKI · Other targeted agentsSelinexor · SIADH / Hyponatremia · Other targeted agentsCladribine · Prerenal / Hemodynamic AKI · AntimetabolitesPentostatin · Acute Tubular Necrosis · AntimetabolitesPegaspargase · Prerenal / Hemodynamic AKI · Cytokines & enzymesInfigratinib · Electrolyte Disturbance · Kinase inhibitors (TKIs)Mobocertinib · Prerenal / Hemodynamic AKI · Kinase inhibitors (TKIs)Larotrectinib · Pseudo-AKI · Other targeted agentsIdecabtagene vicleucel · Prerenal / Hemodynamic AKI · CAR-T cell therapyCiltacabtagene autoleucel · Prerenal / Hemodynamic AKI · CAR-T cell therapyMitoxantrone · Crystal / Obstructive Nephropathy · Antitumor antibioticsIdarubicin · Crystal / Obstructive Nephropathy · Antitumor antibioticsEstramustine · Prerenal / Hemodynamic AKI · Alkylating agentsAlpelisib · Prerenal / Hemodynamic AKI · Kinase inhibitors (TKIs)Idelalisib · Prerenal / Hemodynamic AKI · Kinase inhibitors (TKIs)Duvelisib · Prerenal / Hemodynamic AKI · Kinase inhibitors (TKIs)Copanlisib · Hypertension · Kinase inhibitors (TKIs)Vismodegib · SIADH / Hyponatremia · Other targeted agentsSonidegib · Acute Tubular Necrosis · Other targeted agentsGlasdegib · Prerenal / Hemodynamic AKI · Other targeted agentsGilteritinib · Prerenal / Hemodynamic AKI · Kinase inhibitors (TKIs)Midostaurin · Prerenal / Hemodynamic AKI · Kinase inhibitors (TKIs)Asciminib · Hypertension · Kinase inhibitors (TKIs)Avapritinib · Prerenal / Hemodynamic AKI · Other targeted agentsRipretinib · Hypertension · Other targeted agentsPexidartinib · Prerenal / Hemodynamic AKI · Kinase inhibitors (TKIs)Tazemetostat · Prerenal / Hemodynamic AKI · Other targeted agentsNeratinib · Prerenal / Hemodynamic AKI · Kinase inhibitors (TKIs)Olutasidenib · Prerenal / Hemodynamic AKI · Other targeted agentsLoncastuximab tesirine · Prerenal / Hemodynamic AKI · Antibody-drug conjugatesTafasitamab · Prerenal / Hemodynamic AKI · Monoclonal antibodies (other)Mogamulizumab · Prerenal / Hemodynamic AKI · Monoclonal antibodies (other)Dinutuximab · Prerenal / Hemodynamic AKI · Monoclonal antibodies (other)Raltitrexed · Acute Tubular Necrosis · AntimetabolitesTrifluridine/tipiracil · Prerenal / Hemodynamic AKI · AntimetabolitesElotuzumab · Pseudo-AKI · Monoclonal antibodies (other)Melphalan flufenamide (melflufen) · Acute Tubular Necrosis · Alkylating agentsProcarbazine · Acute Tubular Necrosis · Alkylating agentsCatumaxomab · Prerenal / Hemodynamic AKI · Bispecifics / T-cell engagersBleomycin · Prerenal / Hemodynamic AKI · Antitumor antibioticsVinflunine · Electrolyte Disturbance · Kinase inhibitors (TKIs)Fotemustine · Chronic Interstitial Nephropathy · Alkylating agentsNimustine (ACNU) · Chronic Interstitial Nephropathy · Alkylating agentsTeniposide · Electrolyte Disturbance · Other targeted agentsDactinomycin (actinomycin D) · Electrolyte Disturbance · Antitumor antibioticsMechlorethamine · Electrolyte Disturbance · Alkylating agentsChlorambucil · SIADH / Hyponatremia · Alkylating agentsAmsacrine · Electrolyte Disturbance · Other targeted agentsAltretamine (hexamethylmelamine) · Prerenal / Hemodynamic AKI · Alkylating agentsTegafur-uracil (UFT) · Thrombotic Microangiopathy · AntimetabolitesDoxifluridine · Thrombotic Microangiopathy · AntimetabolitesCarmofur (HCFU) · Thrombotic Microangiopathy · AntimetabolitesSamarium-153 lexidronam · Acute Tubular Necrosis · RadiopharmaceuticalsBicalutamide · Acute Interstitial Nephritis · Hormonal / endocrineOctreotide · Electrolyte Disturbance · Hormonal / endocrineLanreotide · Electrolyte Disturbance · Hormonal / endocrineMitotane · Electrolyte Disturbance · Alkylating agentsDarolutamide · Electrolyte Disturbance · Hormonal / endocrineStrontium-89 chloride · Acute Tubular Necrosis · RadiopharmaceuticalsTislelizumab · Acute Interstitial Nephritis · Checkpoint inhibitorsToripalimab · Acute Interstitial Nephritis · Checkpoint inhibitorsRetifanlimab · Acute Interstitial Nephritis · Checkpoint inhibitorsCosibelimab · Acute Interstitial Nephritis · Checkpoint inhibitorsIvonescimab · Glomerular Injury / Proteinuria · Bispecifics / T-cell engagersLinvoseltamab · Prerenal / Hemodynamic AKI · Bispecifics / T-cell engagersOlverembatinib · Glomerular Injury / Proteinuria · Kinase inhibitors (TKIs)Vorasidenib · Pseudo-AKI · Other targeted agentsVimseltinib · Pseudo-AKI · Kinase inhibitors (TKIs)Penpulimab · Acute Interstitial Nephritis · Checkpoint inhibitorsSugemalimab · Acute Interstitial Nephritis · Checkpoint inhibitorsTaletrectinib · Pseudo-AKI · Kinase inhibitors (TKIs)Ensartinib · Pseudo-AKI · Kinase inhibitors (TKIs)Inavolisib · Electrolyte Disturbance · Kinase inhibitors (TKIs)Telisotuzumab vedotin (Teliso-V) · Acute Tubular Necrosis · Antibody-drug conjugatesAfamitresgene autoleucel (Afami-cel) · Prerenal / Hemodynamic AKI · Other targeted agentsObecabtagene autoleucel (Obe-cel) · Prerenal / Hemodynamic AKI · CAR-T cell therapySunitinib · Hypertension · Anti-angiogenic (VEGF)Axitinib · Hypertension · Anti-angiogenic (VEGF)Pazopanib · Glomerular Injury / Proteinuria · Anti-angiogenic (VEGF)Ipilimumab · Acute Interstitial Nephritis · Checkpoint inhibitorsNivolumab · Acute Interstitial Nephritis · Checkpoint inhibitorsPembrolizumab · Acute Interstitial Nephritis · Checkpoint inhibitors

263 agents · dot size = FAERS reporting volume · position = clinical-toxicity similarity (2-D MDS). Some catalog agents share an identical fingerprint and are gently fanned out to stay legible.

Figure 1·Anti-cancer agents embedded so proximity encodes a shared kidney-injury phenotype (2-D MDS over injury signature, nephron target, severity, and class).

Every citation in the atlas placed by its publication year and its drug's signature kidney injury. The river's changing composition traces how the field's focus moved — from platinum tubular injury to anti-VEGF vascular disease to the checkpoint-inhibitor interstitial-nephritis era. Hover a year; click a band to isolate an injury.

Hemorrhagic CystitisFanconi SyndromeCrystal / Obstructive NephropathyThrombotic MicroangiopathyAcute Interstitial NephritisPseudo-AKIAcute Tubular NecrosisPrerenal / Hemodynamic AKIHypertensionElectrolyte DisturbanceGlomerular Injury / ProteinuriaSIADH / HyponatremiaChronic Interstitial NephropathyRenal Cysts19801990200020102020

50 years · citations attributed to each drug's signature injury · band thickness = citations that year

Figure 2·Citations per year, stacked by the citing drug's signature kidney injury — the shifting composition traces the field's evolving focus.

The kidney-injury combinations that strike the same agent, ranked by how many agents carry each exact set. The dot column under each bar shows which injuries are in that combination — the multi-way overlaps a pairwise chord can only hint at.

432114131010109876655Acute Tubular NecrosisAcute Interstitial Nephri…Thrombotic MicroangiopathyGlomerular Injury / Prote…Electrolyte DisturbanceCrystal / Obstructive Nep…HypertensionPrerenal / Hemodynamic AKISIADH / HyponatremiaPseudo-AKI

Top 14 injury combinations among profiled agents · bar = number of agents with exactly that set · connected dots = injuries in the combination.

Figure 3·The exact multi-injury combinations profiled agents carry, ranked by frequency — the intersection logic a pairwise chord cannot show.

How long each agent's kidney signal took to reach the literature — from approval (hollow) to its first nephrotoxicity citation (filled). The bar is the lag.

19501960197019801990200020102020MechlorethamineMechlorethamine: approved 1949, first renal report 2011 (62-yr lag) · Alkylating agents62yMethotrexate (high-…Methotrexate (high-dose): approved 1953, first renal report 2010 (57-yr lag) · Antimetabolites57yBusulfanBusulfan: approved 1954, first renal report 2001 (47-yr lag) · Alkylating agents47yMitotaneMitotane: approved 1970, first renal report 2017 (47-yr lag) · Alkylating agents47yChlorambucilChlorambucil: approved 1957, first renal report 1999 (42-yr lag) · Alkylating agents42yThiotepaThiotepa: approved 1959, first renal report 1998 (39-yr lag) · Alkylating agents39yVincristineVincristine: approved 1963, first renal report 2002 (39-yr lag) · Kinase inhibitors (TKIs)39yDoxorubicinDoxorubicin: approved 1974, first renal report 2011 (37-yr lag) · Antitumor antibiotics37yHydroxyureaHydroxyurea: approved 1967, first renal report 2003 (36-yr lag) · Other targeted agents36yDactinomycin (actin…Dactinomycin (actinomycin D): approved 1964, first renal report 1996 (32-yr lag) · Antitumor antibiotics32yTamoxifenTamoxifen: approved 1977, first renal report 2006 (29-yr lag) · Other targeted agents29y5-Fluorouracil5-Fluorouracil: approved 1962, first renal report 1987 (25-yr lag) · Antimetabolites25yIrinotecanIrinotecan: approved 1996, first renal report 2020 (24-yr lag) · Other targeted agents24yPaclitaxelPaclitaxel: approved 1992, first renal report 2015 (23-yr lag) · Other targeted agents23yLeuprolideLeuprolide: approved 1985, first renal report 2007 (22-yr lag) · Hormonal / endocrine22yCisplatinCisplatin: approved 1978, first renal report 1999 (21-yr lag) · Platinum agents21yMelphalanMelphalan: approved 1964, first renal report 1985 (21-yr lag) · Alkylating agents21yCytarabineCytarabine: approved 1969, first renal report 1990 (21-yr lag) · Antimetabolites21yTopotecanTopotecan: approved 1996, first renal report 2015 (19-yr lag) · Other targeted agents19yDocetaxelDocetaxel: approved 1996, first renal report 2015 (19-yr lag) · Other targeted agents19yCyclophosphamideCyclophosphamide: approved 1959, first renal report 1974 (15-yr lag) · Alkylating agents15yDacarbazineDacarbazine: approved 1975, first renal report 1990 (15-yr lag) · Alkylating agents15yVinblastineVinblastine: approved 1965, first renal report 1980 (15-yr lag) · Kinase inhibitors (TKIs)15yProcarbazineProcarbazine: approved 1969, first renal report 1983 (14-yr lag) · Alkylating agents14yPlicamycin (mithram…Plicamycin (mithramycin): approved 1970, first renal report 1983 (13-yr lag) · Antitumor antibiotics13yVinorelbineVinorelbine: approved 1994, first renal report 2007 (13-yr lag) · Kinase inhibitors (TKIs)13yBortezomibBortezomib: approved 2003, first renal report 2015 (12-yr lag) · Other targeted agents12yEtoposideEtoposide: approved 1983, first renal report 1995 (12-yr lag) · Other targeted agents12yIdarubicinIdarubicin: approved 1990, first renal report 2002 (12-yr lag) · Antitumor antibiotics12yNimustine (ACNU)Nimustine (ACNU): approved 1979, first renal report 1991 (12-yr lag) · Alkylating agents12yArsenic trioxideArsenic trioxide: approved 2000, first renal report 2011 (11-yr lag) · Other targeted agents11yRituximabRituximab: approved 1997, first renal report 2008 (11-yr lag) · Monoclonal antibodies (other)11yInterferon-αInterferon-α: approved 1986, first renal report 1997 (11-yr lag) · Cytokines & enzymes11yMitomycin CMitomycin C: approved 1974, first renal report 1984 (10-yr lag) · Antitumor antibiotics10yPamidronatePamidronate: approved 1991, first renal report 2001 (10-yr lag) · Bisphosphonates & bone10yStrontium-89 chlori…Strontium-89 chloride: approved 1993, first renal report 2003 (10-yr lag) · Radiopharmaceuticals10yPegaspargasePegaspargase: approved 1994, first renal report 2003 (9-yr lag) · Cytokines & enzymes9yNilotinibNilotinib: approved 2007, first renal report 2015 (8-yr lag) · Kinase inhibitors (TKIs)8yMitoxantroneMitoxantrone: approved 1987, first renal report 1995 (8-yr lag) · Antitumor antibiotics8yDasatinibDasatinib: approved 2006, first renal report 2013 (7-yr lag) · Kinase inhibitors (TKIs)7yAbemaciclibAbemaciclib: approved 2017, first renal report 2024 (7-yr lag) · Kinase inhibitors (TKIs)7yPazopanibPazopanib: approved 2009, first renal report 2016 (7-yr lag) · Anti-angiogenic (VEGF)7yGemcitabineGemcitabine: approved 1996, first renal report 2002 (6-yr lag) · Antimetabolites6yTegafur-uracil (UFT)Tegafur-uracil (UFT): approved 1984, first renal report 1990 (6-yr lag) · Antimetabolites6ySamarium-153 lexidr…Samarium-153 lexidronam: approved 1997, first renal report 2003 (6-yr lag) · Radiopharmaceuticals6yNelarabineNelarabine: approved 2005, first renal report 2010 (5-yr lag) · Antimetabolites5yDaratumumabDaratumumab: approved 2015, first renal report 2020 (5-yr lag) · Monoclonal antibodies (other)5yOctreotideOctreotide: approved 1988, first renal report 1993 (5-yr lag) · Hormonal / endocrine5yIpilimumabIpilimumab: approved 2011, first renal report 2016 (5-yr lag) · Checkpoint inhibitors5yCarmustine (BCNU)Carmustine (BCNU): approved 1977, first renal report 1981 (4-yr lag) · Alkylating agents4yDecitabineDecitabine: approved 2006, first renal report 2010 (4-yr lag) · Other targeted agents4yBevacizumabBevacizumab: approved 2004, first renal report 2008 (4-yr lag) · Anti-angiogenic (VEGF)4yCrizotinibCrizotinib: approved 2011, first renal report 2015 (4-yr lag) · Kinase inhibitors (TKIs)4yRibociclibRibociclib: approved 2017, first renal report 2021 (4-yr lag) · Kinase inhibitors (TKIs)4yCabazitaxelCabazitaxel: approved 2010, first renal report 2014 (4-yr lag) · Other targeted agents4yAsparaginaseAsparaginase: approved 1978, first renal report 1982 (4-yr lag) · Cytokines & enzymes4yDenosumabDenosumab: approved 2010, first renal report 2014 (4-yr lag) · Bisphosphonates & bone4yRuxolitinibRuxolitinib: approved 2011, first renal report 2015 (4-yr lag) · Other targeted agents4yBleomycinBleomycin: approved 1973, first renal report 1977 (4-yr lag) · Antitumor antibiotics4yCarmofur (HCFU)Carmofur (HCFU): approved 1981, first renal report 1985 (4-yr lag) · Antimetabolites4yOxaliplatinOxaliplatin: approved 2002, first renal report 2005 (3-yr lag) · Platinum agents3yIfosfamideIfosfamide: approved 1988, first renal report 1991 (3-yr lag) · Alkylating agents3yLomustine (CCNU)Lomustine (CCNU): approved 1976, first renal report 1979 (3-yr lag) · Alkylating agents3yCapecitabineCapecitabine: approved 1998, first renal report 2001 (3-yr lag) · Antimetabolites3yLenvatinibLenvatinib: approved 2015, first renal report 2018 (3-yr lag) · Anti-angiogenic (VEGF)3ySirolimusSirolimus: approved 1999, first renal report 2002 (3-yr lag) · Other targeted agents3yCetuximab & Panitum…Cetuximab & Panitumumab: approved 2004, first renal report 2007 (3-yr lag) · Kinase inhibitors (TKIs)3yErlotinibErlotinib: approved 2004, first renal report 2007 (3-yr lag) · Kinase inhibitors (TKIs)3yCAR-T cell therapyCAR-T cell therapy: approved 2017, first renal report 2020 (3-yr lag) · CAR-T cell therapy3yPonatinibPonatinib: approved 2012, first renal report 2015 (3-yr lag) · Kinase inhibitors (TKIs)3yBosutinibBosutinib: approved 2012, first renal report 2015 (3-yr lag) · Kinase inhibitors (TKIs)3yNiraparibNiraparib: approved 2017, first renal report 2020 (3-yr lag) · Other targeted agents3yPalbociclibPalbociclib: approved 2015, first renal report 2018 (3-yr lag) · Kinase inhibitors (TKIs)3yCatumaxomabCatumaxomab: approved 2009, first renal report 2012 (3-yr lag) · Bispecifics / T-cell engagers3yPemetrexedPemetrexed: approved 2004, first renal report 2006 (2-yr lag) · Antimetabolites2yVEGFR TKIs (sunitin…VEGFR TKIs (sunitinib · sorafenib · pazopanib · axitinib): approved 2006, first renal report 2008 (2-yr lag) · Anti-angiogenic (VEGF)2yCheckpoint inhibito…Checkpoint inhibitors (pembrolizumab · nivolumab · ipilimumab): approved 2014, first renal report 2016 (2-yr lag) · Checkpoint inhibitors2yTrastuzumab emtansi…Trastuzumab emtansine (T-DM1): approved 2013, first renal report 2015 (2-yr lag) · Antibody-drug conjugates2yBrentuximab vedotinBrentuximab vedotin: approved 2011, first renal report 2013 (2-yr lag) · Antibody-drug conjugates2yCarfilzomibCarfilzomib: approved 2012, first renal report 2014 (2-yr lag) · Other targeted agents2yIxazomibIxazomib: approved 2015, first renal report 2017 (2-yr lag) · Other targeted agents2yLenalidomideLenalidomide: approved 2005, first renal report 2007 (2-yr lag) · Other targeted agents2yThalidomideThalidomide: approved 2006, first renal report 2008 (2-yr lag) · Other targeted agents2yImatinibImatinib: approved 2001, first renal report 2003 (2-yr lag) · Kinase inhibitors (TKIs)2yBRAF / MEK inhibito…BRAF / MEK inhibitors (vemurafenib · dabrafenib · trametinib): approved 2011, first renal report 2013 (2-yr lag) · Kinase inhibitors (TKIs)2yIbrutinibIbrutinib: approved 2013, first renal report 2015 (2-yr lag) · Kinase inhibitors (TKIs)2yTretinoin (ATRA)Tretinoin (ATRA): approved 1995, first renal report 1997 (2-yr lag) · Kinase inhibitors (TKIs)2yTagraxofuspTagraxofusp: approved 2018, first renal report 2020 (2-yr lag) · Other targeted agents2yZoledronic acidZoledronic acid: approved 2001, first renal report 2003 (2-yr lag) · Bisphosphonates & bone2yEnzalutamideEnzalutamide: approved 2012, first renal report 2014 (2-yr lag) · Hormonal / endocrine2y

90 agents with both an approval year and a dated citation · hollow = approval · filled = first renal citation · bar = years to first documented signal.

Figure 4·From approval to the first nephrotoxicity citation for each agent — the lag before a kidney signal reached the literature.

Every profiled agent by evidence depth (citations, horizontal) and recency (newest reference, vertical). The crosshairs are the medians — the upper-left quadrant is the frontier (fresh but thin), the lower-right is deep but aging.

emerging · fresh & thinestablished · deep & aging13510201995200020052010201520202025citations (log)Cisplatin · 14 citations · newest 2025 · Acute Tubular NecrosisCarboplatin · 8 citations · newest 2021 · Acute Tubular NecrosisOxaliplatin · 10 citations · newest 2026 · Thrombotic MicroangiopathyIfosfamide · 12 citations · newest 2026 · Fanconi SyndromeCyclophosphamide · 7 citations · newest 2023 · SIADH / HyponatremiaMethotrexate (high-dose) · 10 citations · newest 2025 · Crystal / Obstructive NephropathyPemetrexed · 9 citations · newest 2026 · Acute Tubular NecrosisGemcitabine · 9 citations · newest 2025 · Thrombotic MicroangiopathyMitomycin C · 10 citations · newest 2025 · Thrombotic MicroangiopathyBevacizumab · 8 citations · newest 2019 · Glomerular Injury / ProteinuriaVEGFR TKIs (sunitinib · sorafenib · pazopanib · axitinib) · 8 citations · newest 2024 · HypertensionmTOR inhibitors (everolimus · temsirolimus) · 8 citations · newest 2019 · Glomerular Injury / ProteinuriaCetuximab & Panitumumab · 8 citations · newest 2022 · Electrolyte DisturbanceCheckpoint inhibitors (pembrolizumab · nivolumab · ipilimumab) · 8 citations · newest 2023 · Acute Interstitial NephritisCAR-T cell therapy · 9 citations · newest 2025 · Prerenal / Hemodynamic AKIInterferon-α · 8 citations · newest 2025 · Glomerular Injury / ProteinuriaInterleukin-2 (high-dose) · 7 citations · newest 1994 · Prerenal / Hemodynamic AKIZoledronic acid · 8 citations · newest 2026 · Acute Tubular NecrosisPamidronate · 5 citations · newest 2011 · Glomerular Injury / ProteinuriaBRAF / MEK inhibitors (vemurafenib · dabrafenib · trametinib) · 7 citations · newest 2022 · Acute Tubular NecrosisNedaplatin · 10 citations · newest 2023 · Acute Tubular NecrosisStreptozocin · 9 citations · newest 2026 · Fanconi SyndromeCarmustine (BCNU) · 7 citations · newest 2012 · Chronic Interstitial NephropathyLomustine (CCNU) · 9 citations · newest 2019 · Chronic Interstitial NephropathyBendamustine · 10 citations · newest 2026 · Crystal / Obstructive NephropathyMelphalan · 7 citations · newest 2007 · SIADH / HyponatremiaBusulfan · 8 citations · newest 2019 · Thrombotic MicroangiopathyTemozolomide · 9 citations · newest 2025 · SIADH / HyponatremiaDacarbazine · 2 citations · newest 2001 · Prerenal / Hemodynamic AKIThiotepa · 8 citations · newest 2024 · Hemorrhagic CystitisPralatrexate · 8 citations · newest 2022 · Crystal / Obstructive Nephropathy5-Fluorouracil · 9 citations · newest 2024 · Thrombotic MicroangiopathyCapecitabine · 9 citations · newest 2025 · Prerenal / Hemodynamic AKICytarabine · 8 citations · newest 2023 · Prerenal / Hemodynamic AKIFludarabine · 10 citations · newest 2017 · Crystal / Obstructive NephropathyClofarabine · 9 citations · newest 2020 · Prerenal / Hemodynamic AKIAzacitidine · 8 citations · newest 2024 · Acute Tubular NecrosisDecitabine · 6 citations · newest 2023 · Prerenal / Hemodynamic AKIHydroxyurea · 7 citations · newest 2020 · Prerenal / Hemodynamic AKINelarabine · 6 citations · newest 2020 · Prerenal / Hemodynamic AKIDoxorubicin · 9 citations · newest 2026 · Glomerular Injury / ProteinuriaPlicamycin (mithramycin) · 8 citations · newest 2017 · Acute Tubular NecrosisRamucirumab · 10 citations · newest 2025 · HypertensionZiv-aflibercept · 7 citations · newest 2022 · HypertensionLenvatinib · 13 citations · newest 2026 · HypertensionCabozantinib · 9 citations · newest 2026 · HypertensionRegorafenib · 8 citations · newest 2025 · HypertensionVandetanib · 6 citations · newest 2023 · HypertensionTivozanib · 5 citations · newest 2021 · HypertensionNintedanib · 9 citations · newest 2026 · HypertensionSirolimus · 12 citations · newest 2019 · Glomerular Injury / ProteinuriaNecitumumab · 9 citations · newest 2021 · Electrolyte DisturbanceOsimertinib · 9 citations · newest 2026 · SIADH / HyponatremiaErlotinib · 8 citations · newest 2024 · Glomerular Injury / ProteinuriaGefitinib · 9 citations · newest 2018 · Glomerular Injury / ProteinuriaAfatinib · 8 citations · newest 2024 · Prerenal / Hemodynamic AKIAtezolizumab · 10 citations · newest 2024 · Acute Interstitial NephritisDurvalumab · 10 citations · newest 2026 · Acute Interstitial NephritisAvelumab · 7 citations · newest 2024 · Acute Interstitial NephritisCemiplimab · 9 citations · newest 2026 · Acute Interstitial NephritisDostarlimab · 8 citations · newest 2025 · Acute Interstitial NephritisBlinatumomab · 8 citations · newest 2022 · Prerenal / Hemodynamic AKITeclistamab · 8 citations · newest 2026 · Prerenal / Hemodynamic AKITalquetamab · 7 citations · newest 2026 · Prerenal / Hemodynamic AKIElranatamab · 10 citations · newest 2026 · Prerenal / Hemodynamic AKIMosunetuzumab · 7 citations · newest 2024 · Prerenal / Hemodynamic AKIEpcoritamab · 8 citations · newest 2026 · Prerenal / Hemodynamic AKIGlofitamab · 6 citations · newest 2024 · Prerenal / Hemodynamic AKIEnfortumab vedotin · 10 citations · newest 2025 · Acute Tubular NecrosisSacituzumab govitecan · 5 citations · newest 2026 · Prerenal / Hemodynamic AKITrastuzumab deruxtecan · 6 citations · newest 2026 · Acute Tubular NecrosisTrastuzumab emtansine (T-DM1) · 5 citations · newest 2026 · Thrombotic MicroangiopathyBrentuximab vedotin · 5 citations · newest 2024 · Electrolyte DisturbancePolatuzumab vedotin · 4 citations · newest 2024 · Prerenal / Hemodynamic AKIBelantamab mafodotin · 6 citations · newest 2026 · Glomerular Injury / ProteinuriaMirvetuximab soravtansine · 4 citations · newest 2024 · Prerenal / Hemodynamic AKIGemtuzumab ozogamicin · 4 citations · newest 2020 · Prerenal / Hemodynamic AKIInotuzumab ozogamicin · 4 citations · newest 2023 · Prerenal / Hemodynamic AKICarfilzomib · 13 citations · newest 2025 · Thrombotic MicroangiopathyBortezomib · 7 citations · newest 2025 · Thrombotic MicroangiopathyIxazomib · 8 citations · newest 2025 · Thrombotic MicroangiopathyLenalidomide · 9 citations · newest 2025 · Acute Tubular NecrosisPomalidomide · 7 citations · newest 2025 · Prerenal / Hemodynamic AKIThalidomide · 6 citations · newest 2017 · Prerenal / Hemodynamic AKIImatinib · 9 citations · newest 2024 · Electrolyte DisturbanceDasatinib · 9 citations · newest 2025 · Glomerular Injury / ProteinuriaNilotinib · 8 citations · newest 2025 · Prerenal / Hemodynamic AKIPonatinib · 9 citations · newest 2025 · HypertensionBosutinib · 9 citations · newest 2025 · Pseudo-AKICrizotinib · 9 citations · newest 2025 · Renal CystsAlectinib · 9 citations · newest 2026 · Pseudo-AKIBrigatinib · 7 citations · newest 2025 · Pseudo-AKILorlatinib · 8 citations · newest 2025 · Pseudo-AKICeritinib · 6 citations · newest 2025 · Prerenal / Hemodynamic AKIOlaparib · 7 citations · newest 2026 · Pseudo-AKINiraparib · 8 citations · newest 2026 · HypertensionRucaparib · 6 citations · newest 2026 · Pseudo-AKITalazoparib · 6 citations · newest 2026 · Pseudo-AKIEncorafenib · 9 citations · newest 2022 · Acute Tubular NecrosisCobimetinib · 7 citations · newest 2022 · Acute Tubular NecrosisBinimetinib · 9 citations · newest 2022 · Prerenal / Hemodynamic AKISelumetinib · 6 citations · newest 2023 · Prerenal / Hemodynamic AKIErdafitinib · 7 citations · newest 2024 · Electrolyte DisturbancePemigatinib · 9 citations · newest 2025 · Electrolyte DisturbanceFutibatinib · 6 citations · newest 2024 · Electrolyte DisturbanceSelpercatinib · 9 citations · newest 2026 · HypertensionPralsetinib · 6 citations · newest 2025 · HypertensionCapmatinib · 8 citations · newest 2025 · Pseudo-AKITepotinib · 7 citations · newest 2025 · Pseudo-AKIIvosidenib · 6 citations · newest 2024 · Prerenal / Hemodynamic AKIEnasidenib · 8 citations · newest 2025 · Prerenal / Hemodynamic AKISotorasib · 6 citations · newest 2025 · Prerenal / Hemodynamic AKIAdagrasib · 6 citations · newest 2025 · Prerenal / Hemodynamic AKIBelzutifan · 7 citations · newest 2025 · Prerenal / Hemodynamic AKIIbrutinib · 9 citations · newest 2025 · HypertensionAcalabrutinib · 8 citations · newest 2025 · HypertensionZanubrutinib · 7 citations · newest 2024 · Prerenal / Hemodynamic AKIVenetoclax · 12 citations · newest 2025 · Crystal / Obstructive NephropathyTretinoin (ATRA) · 10 citations · newest 2025 · Prerenal / Hemodynamic AKIArsenic trioxide · 9 citations · newest 2025 · Prerenal / Hemodynamic AKIRituximab · 8 citations · newest 2024 · Crystal / Obstructive NephropathyObinutuzumab · 8 citations · newest 2025 · Crystal / Obstructive NephropathyDaratumumab · 9 citations · newest 2025 · Prerenal / Hemodynamic AKIIsatuximab · 7 citations · newest 2025 · Prerenal / Hemodynamic AKIAbemaciclib · 8 citations · newest 2026 · Pseudo-AKIPalbociclib · 8 citations · newest 2026 · Pseudo-AKIRibociclib · 9 citations · newest 2026 · Pseudo-AKITagraxofusp · 7 citations · newest 2026 · Prerenal / Hemodynamic AKIIrinotecan · 5 citations · newest 2024 · Prerenal / Hemodynamic AKITopotecan · 4 citations · newest 2022 · Prerenal / Hemodynamic AKIEtoposide · 9 citations · newest 2021 · Prerenal / Hemodynamic AKIVincristine · 9 citations · newest 2024 · SIADH / HyponatremiaVinblastine · 8 citations · newest 2024 · SIADH / HyponatremiaVinorelbine · 7 citations · newest 2024 · SIADH / HyponatremiaPaclitaxel · 6 citations · newest 2022 · Prerenal / Hemodynamic AKIDocetaxel · 6 citations · newest 2024 · Prerenal / Hemodynamic AKICabazitaxel · 6 citations · newest 2022 · Prerenal / Hemodynamic AKIEribulin · 6 citations · newest 2022 · Prerenal / Hemodynamic AKIAsparaginase · 6 citations · newest 2025 · Prerenal / Hemodynamic AKIDenosumab · 9 citations · newest 2025 · Electrolyte DisturbanceIbandronate · 8 citations · newest 2024 · Acute Tubular NecrosisAbiraterone · 10 citations · newest 2025 · Electrolyte DisturbanceEnzalutamide · 8 citations · newest 2024 · HypertensionTamoxifen · 6 citations · newest 2023 · SIADH / HyponatremiaLeuprolide · 7 citations · newest 2024 · HypertensionAmivantamab · 7 citations · newest 2025 · Acute Interstitial NephritisDatopotamab deruxtecan (Dato-DXd) · 6 citations · newest 2025 · Acute Tubular NecrosisTarlatamab · 8 citations · newest 2026 · Prerenal / Hemodynamic AKIRevumenib · 6 citations · newest 2024 · Prerenal / Hemodynamic AKIFruquintinib · 10 citations · newest 2025 · HypertensionPirtobrutinib · 6 citations · newest 2024 · Crystal / Obstructive NephropathyCapivasertib · 8 citations · newest 2026 · Prerenal / Hemodynamic AKINirogacestat · 7 citations · newest 2024 · Electrolyte DisturbanceLazertinib · 6 citations · newest 2024 · SIADH / HyponatremiaRepotrectinib · 6 citations · newest 2025 · Pseudo-AKIZanidatamab · 5 citations · newest 2025 · Prerenal / Hemodynamic AKILifileucel · 6 citations · newest 2025 · Prerenal / Hemodynamic AKITovorafenib · 4 citations · newest 2024 · Prerenal / Hemodynamic AKIImetelstat · 5 citations · newest 2024 · Prerenal / Hemodynamic AKIMirdametinib · 4 citations · newest 2024 · Prerenal / Hemodynamic AKISunvozertinib · 4 citations · newest 2024 · SIADH / HyponatremiaTucatinib · 4 citations · newest 2024 · Pseudo-AKIRuxolitinib · 6 citations · newest 2026 · Prerenal / Hemodynamic AKIMomelotinib · 7 citations · newest 2026 · Pseudo-AKIEntrectinib · 7 citations · newest 2024 · Pseudo-AKIQuizartinib · 5 citations · newest 2025 · Prerenal / Hemodynamic AKIZiftomenib · 5 citations · newest 2026 · Prerenal / Hemodynamic AKICasdatifan · 4 citations · newest 2026 · Prerenal / Hemodynamic AKIZongertinib · 4 citations · newest 2025 · Pseudo-AKILutetium-177 Dotatate · 13 citations · newest 2025 · Chronic Interstitial NephropathyLutetium-177 PSMA-617 (vipivotide) · 7 citations · newest 2025 · Chronic Interstitial NephropathyIbritumomab tiuxetan · 6 citations · newest 2004 · Prerenal / Hemodynamic AKIRadium-223 dichloride · 6 citations · newest 2020 · Prerenal / Hemodynamic AKITrabectedin · 9 citations · newest 2019 · Acute Tubular NecrosisLurbinectedin · 8 citations · newest 2025 · Acute Tubular NecrosisMoxetumomab pasudotox · 8 citations · newest 2020 · Thrombotic MicroangiopathyDenileukin diftitox · 8 citations · newest 2025 · Prerenal / Hemodynamic AKISelinexor · 9 citations · newest 2024 · SIADH / HyponatremiaCladribine · 10 citations · newest 2023 · Prerenal / Hemodynamic AKIPentostatin · 10 citations · newest 2013 · Acute Tubular NecrosisPegaspargase · 8 citations · newest 2020 · Prerenal / Hemodynamic AKIInfigratinib · 7 citations · newest 2025 · Electrolyte DisturbanceMobocertinib · 7 citations · newest 2025 · Prerenal / Hemodynamic AKILarotrectinib · 7 citations · newest 2020 · Pseudo-AKIIdecabtagene vicleucel · 9 citations · newest 2026 · Prerenal / Hemodynamic AKICiltacabtagene autoleucel · 9 citations · newest 2026 · Prerenal / Hemodynamic AKIMitoxantrone · 7 citations · newest 2016 · Crystal / Obstructive NephropathyIdarubicin · 8 citations · newest 2023 · Crystal / Obstructive NephropathyEstramustine · 7 citations · newest 2015 · Prerenal / Hemodynamic AKIAlpelisib · 7 citations · newest 2024 · Prerenal / Hemodynamic AKIIdelalisib · 6 citations · newest 2021 · Prerenal / Hemodynamic AKIDuvelisib · 7 citations · newest 2025 · Prerenal / Hemodynamic AKICopanlisib · 6 citations · newest 2021 · HypertensionVismodegib · 6 citations · newest 2023 · SIADH / HyponatremiaSonidegib · 6 citations · newest 2023 · Acute Tubular NecrosisGlasdegib · 6 citations · newest 2023 · Prerenal / Hemodynamic AKIGilteritinib · 7 citations · newest 2026 · Prerenal / Hemodynamic AKIMidostaurin · 7 citations · newest 2023 · Prerenal / Hemodynamic AKIAsciminib · 6 citations · newest 2024 · HypertensionAvapritinib · 5 citations · newest 2021 · Prerenal / Hemodynamic AKIRipretinib · 7 citations · newest 2026 · HypertensionPexidartinib · 5 citations · newest 2023 · Prerenal / Hemodynamic AKITazemetostat · 6 citations · newest 2021 · Prerenal / Hemodynamic AKINeratinib · 6 citations · newest 2022 · Prerenal / Hemodynamic AKIOlutasidenib · 6 citations · newest 2025 · Prerenal / Hemodynamic AKILoncastuximab tesirine · 5 citations · newest 2024 · Prerenal / Hemodynamic AKITafasitamab · 6 citations · newest 2024 · Prerenal / Hemodynamic AKIMogamulizumab · 6 citations · newest 2021 · Prerenal / Hemodynamic AKIDinutuximab · 7 citations · newest 2025 · Prerenal / Hemodynamic AKITisotumab vedotin · 4 citations · newest 2024 · Prerenal / Hemodynamic AKITebentafusp · 4 citations · newest 2023 · Prerenal / Hemodynamic AKIZolbetuximab · 4 citations · newest 2025 · Prerenal / Hemodynamic AKIElacestrant · 4 citations · newest 2024 · Prerenal / Hemodynamic AKIRelatlimab · 7 citations · newest 2026 · Acute Interstitial NephritisRaltitrexed · 4 citations · newest 2021 · Acute Tubular NecrosisTrifluridine/tipiracil · 7 citations · newest 2025 · Prerenal / Hemodynamic AKIElotuzumab · 4 citations · newest 2017 · Pseudo-AKIMelphalan flufenamide (melflufen) · 4 citations · newest 2026 · Acute Tubular NecrosisProcarbazine · 4 citations · newest 2021 · Acute Tubular NecrosisCatumaxomab · 4 citations · newest 2017 · Prerenal / Hemodynamic AKIBleomycin · 7 citations · newest 2021 · Prerenal / Hemodynamic AKIVinflunine · 4 citations · newest 2019 · Electrolyte DisturbanceFotemustine · 4 citations · newest 2015 · Chronic Interstitial NephropathyNimustine (ACNU) · 4 citations · newest 2023 · Chronic Interstitial NephropathyTeniposide · 4 citations · newest 2021 · Electrolyte DisturbanceDactinomycin (actinomycin D) · 4 citations · newest 2017 · Electrolyte DisturbanceMechlorethamine · 4 citations · newest 2021 · Electrolyte DisturbanceChlorambucil · 3 citations · newest 2021 · SIADH / HyponatremiaAmsacrine · 4 citations · newest 2017 · Electrolyte DisturbanceAltretamine (hexamethylmelamine) · 3 citations · newest 2017 · Prerenal / Hemodynamic AKITegafur-uracil (UFT) · 4 citations · newest 2021 · Thrombotic MicroangiopathyDoxifluridine · 4 citations · newest 2021 · Thrombotic MicroangiopathyCarmofur (HCFU) · 3 citations · newest 2021 · Thrombotic MicroangiopathySamarium-153 lexidronam · 4 citations · newest 2014 · Acute Tubular NecrosisBicalutamide · 4 citations · newest 2020 · Acute Interstitial NephritisOctreotide · 7 citations · newest 2024 · Electrolyte DisturbanceLanreotide · 6 citations · newest 2018 · Electrolyte DisturbanceMitotane · 6 citations · newest 2025 · Electrolyte DisturbanceDarolutamide · 5 citations · newest 2025 · Electrolyte DisturbanceStrontium-89 chloride · 4 citations · newest 2021 · Acute Tubular NecrosisTislelizumab · 8 citations · newest 2026 · Acute Interstitial NephritisToripalimab · 7 citations · newest 2024 · Acute Interstitial NephritisRetifanlimab · 6 citations · newest 2025 · Acute Interstitial NephritisCosibelimab · 5 citations · newest 2025 · Acute Interstitial NephritisIvonescimab · 5 citations · newest 2025 · Glomerular Injury / ProteinuriaLinvoseltamab · 6 citations · newest 2025 · Prerenal / Hemodynamic AKIOlverembatinib · 5 citations · newest 2026 · Glomerular Injury / ProteinuriaVorasidenib · 4 citations · newest 2026 · Pseudo-AKIVimseltinib · 5 citations · newest 2025 · Pseudo-AKIPenpulimab · 5 citations · newest 2026 · Acute Interstitial NephritisSugemalimab · 4 citations · newest 2024 · Acute Interstitial NephritisTaletrectinib · 4 citations · newest 2026 · Pseudo-AKIEnsartinib · 4 citations · newest 2025 · Pseudo-AKIInavolisib · 4 citations · newest 2024 · Electrolyte DisturbanceTelisotuzumab vedotin (Teliso-V) · 3 citations · newest 2025 · Acute Tubular NecrosisAfamitresgene autoleucel (Afami-cel) · 4 citations · newest 2025 · Prerenal / Hemodynamic AKIObecabtagene autoleucel (Obe-cel) · 5 citations · newest 2025 · Prerenal / Hemodynamic AKISunitinib · 7 citations · newest 2025 · HypertensionAxitinib · 7 citations · newest 2023 · HypertensionPazopanib · 8 citations · newest 2024 · Glomerular Injury / ProteinuriaIpilimumab · 10 citations · newest 2026 · Acute Interstitial NephritisNivolumab · 9 citations · newest 2026 · Acute Interstitial NephritisPembrolizumab · 9 citations · newest 2024 · Acute Interstitial Nephritis

263 profiled agents · x = citation count (log) · y = newest citation year · crosshair = medians.

Figure 5·Each profiled agent by citation depth (x) and newest-reference recency (y); median crosshairs split established, emerging, mature, and thin/stale.

Each agent's acute-kidney-injury reporting odds ratio (horizontal, log) against its AKI report count (vertical, log). Dots to the right of the ROR = 1 line report AKI disproportionately; those high and right are the loudest, best-populated renal signals. Size = total report volume.

ROR = 10.5×1×2×4×101001000AKI reporting odds ratio (log)Interleukin-2 (high-dose): ROR 4.95 (95% CI 3.636–6.73), 42 AKI reports — signalPemetrexed: ROR 4.88 (95% CI 4.611–5.163), 1,255 AKI reports — signalSirolimus: ROR 4.7 (95% CI 4.269–5.177), 429 AKI reports — signalClofarabine: ROR 4.52 (95% CI 3.574–5.717), 72 AKI reports — signalCarfilzomib: ROR 4.37 (95% CI 4.08–4.678), 854 AKI reports — signalCisplatin: ROR 3.35 (95% CI 3.195–3.51), 1,804 AKI reports — signalMelphalan: ROR 3.27 (95% CI 3.012–3.555), 575 AKI reports — signalFludarabine: ROR 3.26 (95% CI 3.048–3.484), 887 AKI reports — signalAvelumab: ROR 3.08 (95% CI 2.493–3.814), 87 AKI reports — signalThiotepa: ROR 2.98 (95% CI 2.587–3.432), 197 AKI reports — signalIfosfamide: ROR 2.95 (95% CI 2.68–3.238), 439 AKI reports — signalCarboplatin: ROR 2.9 (95% CI 2.791–3.022), 2,518 AKI reports — signalCytarabine: ROR 2.87 (95% CI 2.711–3.035), 1,238 AKI reports — signalInotuzumab ozogamicin: ROR 2.78 (95% CI 2.137–3.611), 57 AKI reports — signalGemcitabine: ROR 2.73 (95% CI 2.561–2.904), 1,003 AKI reports — signalAtezolizumab: ROR 2.68 (95% CI 2.491–2.889), 717 AKI reports — signalEnfortumab vedotin: ROR 2.66 (95% CI 2.229–3.18), 124 AKI reports — signalElotuzumab: ROR 2.6 (95% CI 2.123–3.187), 95 AKI reports — signalBrentuximab vedotin: ROR 2.58 (95% CI 2.232–2.988), 184 AKI reports — signalBendamustine: ROR 2.55 (95% CI 2.332–2.789), 489 AKI reports — signalStreptozocin: ROR 2.49 (95% CI 0.926–6.694), 4 AKI reportsCarmustine (BCNU): ROR 2.39 (95% CI 1.913–2.994), 78 AKI reports — signalBusulfan: ROR 2.38 (95% CI 2.129–2.668), 308 AKI reports — signalNelarabine: ROR 2.35 (95% CI 1.434–3.854), 16 AKI reports — signalOxaliplatin: ROR 2.34 (95% CI 2.206–2.474), 1,200 AKI reports — signalCemiplimab: ROR 2.29 (95% CI 1.607–3.268), 31 AKI reports — signalLenvatinib: ROR 2.23 (95% CI 2.044–2.437), 507 AKI reports — signalCyclophosphamide: ROR 2.19 (95% CI 2.107–2.276), 2,685 AKI reports — signalBelantamab mafodotin: ROR 2.13 (95% CI 1.573–2.893), 42 AKI reports — signal5-Fluorouracil: ROR 2.12 (95% CI 1.997–2.246), 1,140 AKI reports — signalDoxorubicin: ROR 2.09 (95% CI 1.978–2.2), 1,392 AKI reports — signalAfatinib: ROR 2.02 (95% CI 1.647–2.469), 95 AKI reports — signalGemtuzumab ozogamicin: ROR 1.89 (95% CI 1.422–2.499), 49 AKI reports — signalBortezomib: ROR 1.88 (95% CI 1.775–1.992), 1,181 AKI reports — signalDecitabine: ROR 1.77 (95% CI 1.383–2.273), 63 AKI reports — signalHydroxyurea: ROR 1.74 (95% CI 1.536–1.962), 259 AKI reports — signalTalquetamab: ROR 1.74 (95% CI 1.151–2.62), 23 AKI reports — signalBicalutamide: ROR 1.72 (95% CI 1.485–1.983), 186 AKI reports — signalAzacitidine: ROR 1.67 (95% CI 1.501–1.856), 346 AKI reports — signalPolatuzumab vedotin: ROR 1.63 (95% CI 1.345–1.97), 107 AKI reports — signalDostarlimab: ROR 1.51 (95% CI 0.994–2.304), 22 AKI reportsRamucirumab: ROR 1.31 (95% CI 1.014–1.7), 58 AKI reports — signalDurvalumab: ROR 1.28 (95% CI 1.105–1.489), 174 AKI reports — signalGlofitamab: ROR 1.28 (95% CI 0.817–2.016), 19 AKI reportsTemozolomide: ROR 1.27 (95% CI 1.096–1.46), 189 AKI reports — signalBleomycin: ROR 1.26 (95% CI 1.03–1.55), 93 AKI reports — signalDacarbazine: ROR 1.24 (95% CI 0.971–1.582), 65 AKI reportsMethotrexate (high-dose): ROR 1.24 (95% CI 1.204–1.279), 4,329 AKI reports — signalBevacizumab: ROR 1.23 (95% CI 1.159–1.304), 1,122 AKI reports — signalPamidronate: ROR 1.23 (95% CI 0.859–1.763), 30 AKI reportsBlinatumomab: ROR 1.2 (95% CI 0.974–1.483), 88 AKI reportsRegorafenib: ROR 1.18 (95% CI 0.97–1.444), 98 AKI reportsVandetanib: ROR 1.17 (95% CI 0.703–1.943), 15 AKI reportsProcarbazine: ROR 1.17 (95% CI 0.85–1.611), 38 AKI reportsMosunetuzumab: ROR 1.16 (95% CI 0.552–2.445), 7 AKI reportsTrifluridine/tipiracil: ROR 1.15 (95% CI 0.937–1.417), 91 AKI reportsTeclistamab: ROR 1.06 (95% CI 0.637–1.761), 15 AKI reportsChlorambucil: ROR 1.06 (95% CI 0.743–1.525), 30 AKI reportsMitomycin C: ROR 1.03 (95% CI 0.692–1.545), 24 AKI reportsCapecitabine: ROR 1.02 (95% CI 0.947–1.103), 667 AKI reportsOctreotide: ROR 1.02 (95% CI 0.897–1.165), 226 AKI reportsSacituzumab govitecan: ROR 1.01 (95% CI 0.709–1.436), 31 AKI reportsMitotane: ROR 0.95 (95% CI 0.54–1.68), 12 AKI reportsErlotinib: ROR 0.91 (95% CI 0.734–1.133), 82 AKI reportsDactinomycin (actinomycin D): ROR 0.89 (95% CI 0.526–1.503), 14 AKI reportsNintedanib: ROR 0.82 (95% CI 0.708–0.95), 178 AKI reportsElranatamab: ROR 0.78 (95% CI 0.325–1.887), 5 AKI reportsLomustine (CCNU): ROR 0.72 (95% CI 0.415–1.235), 13 AKI reportsTrastuzumab deruxtecan: ROR 0.7 (95% CI 0.529–0.938), 47 AKI reportsTrastuzumab emtansine (T-DM1): ROR 0.68 (95% CI 0.502–0.927), 41 AKI reportsCabozantinib: ROR 0.67 (95% CI 0.586–0.76), 228 AKI reportsDarolutamide: ROR 0.64 (95% CI 0.432–0.963), 24 AKI reportsTivozanib: ROR 0.63 (95% CI 0.299–1.321), 7 AKI reportsEpcoritamab: ROR 0.59 (95% CI 0.245–1.417), 5 AKI reportsZiv-aflibercept: ROR 0.52 (95% CI 0.431–0.618), 120 AKI reportsLanreotide: ROR 0.51 (95% CI 0.348–0.732), 28 AKI reportsOsimertinib: ROR 0.46 (95% CI 0.374–0.553), 101 AKI reportsPralatrexate: ROR 0.43 (95% CI 0.106–1.71), 2 AKI reportsGefitinib: ROR 0.32 (95% CI 0.21–0.494), 21 AKI reportsMechlorethamine: ROR 0.06 (95% CI 0.009–0.435), 1 AKI reports

80 agents with a computed AKI ROR · filled = 95% CI lower bound > 1 (a disproportionality signal) · size = total FAERS reports. Reporting, not incidence.

Figure 6·FAERS acute-kidney-injury reporting odds ratio (x, log) vs AKI report count (y, log); right of the ROR = 1 line reports AKI disproportionately.

Every profiled agent as a row; the 14 kidney injuries as columns. A colored tick means the agent carries that injury. Grouped by drug class, the class signatures read at a glance — whole families lighting up the same columns. Tap a column header to isolate an injury.

Kinase inhibitors (TKIs) · 70
Abemaciclib
Acalabrutinib
Adagrasib
Afatinib
Alectinib
Alpelisib
Asciminib
Binimetinib
Bosutinib
BRAF / MEK inhibitors (vemurafenib · dabrafenib · trametinib)
Brigatinib
Capivasertib
Capmatinib
Ceritinib
Cetuximab & Panitumumab
Cobimetinib
Copanlisib
Crizotinib
Dasatinib
Duvelisib
Encorafenib
Ensartinib
Entrectinib
Erdafitinib
Erlotinib
Futibatinib
Gefitinib
Gilteritinib
Ibrutinib
Idelalisib
Imatinib
Inavolisib
Infigratinib
Lazertinib
Lorlatinib
Midostaurin
Mirdametinib
Mobocertinib
Necitumumab
Neratinib
Nilotinib
Nirogacestat
Olverembatinib
Osimertinib
Palbociclib
Pemigatinib
Pexidartinib
Pirtobrutinib
Ponatinib
Pralsetinib
Quizartinib
Repotrectinib
Revumenib
Ribociclib
Selpercatinib
Selumetinib
Sotorasib
Sunvozertinib
Taletrectinib
Tepotinib
Tretinoin (ATRA)
Tucatinib
Vimseltinib
Vinblastine
Vincristine
Vinflunine
Vinorelbine
Zanubrutinib
Ziftomenib
Zongertinib
Other targeted agents · 51
Afamitresgene autoleucel (Afami-cel)
Amsacrine
Arsenic trioxide
Avapritinib
Azacitidine
Belzutifan
Bortezomib
Cabazitaxel
Carfilzomib
Casdatifan
Decitabine
Denileukin diftitox
Docetaxel
Enasidenib
Eribulin
Etoposide
Glasdegib
Hydroxyurea
Ibritumomab tiuxetan
Imetelstat
Irinotecan
Ivosidenib
Ixazomib
Larotrectinib
Lenalidomide
Lifileucel
Momelotinib
Moxetumomab pasudotox
mTOR inhibitors (everolimus · temsirolimus)
Niraparib
Olaparib
Olutasidenib
Paclitaxel
Pomalidomide
Ripretinib
Rucaparib
Ruxolitinib
Selinexor
Sirolimus
Sonidegib
Tagraxofusp
Talazoparib
Tamoxifen
Tazemetostat
Teniposide
Thalidomide
Topotecan
Tovorafenib
Venetoclax
Vismodegib
Vorasidenib
Alkylating agents · 22
Altretamine (hexamethylmelamine)
Bendamustine
Busulfan
Carmustine (BCNU)
Chlorambucil
Cyclophosphamide
Dacarbazine
Estramustine
Fotemustine
Ifosfamide
Lomustine (CCNU)
Lurbinectedin
Mechlorethamine
Melphalan
Melphalan flufenamide (melflufen)
Mitotane
Nimustine (ACNU)
Procarbazine
Streptozocin
Temozolomide
Thiotepa
Trabectedin
Antimetabolites · 17
5-Fluorouracil
Capecitabine
Carmofur (HCFU)
Cladribine
Clofarabine
Cytarabine
Doxifluridine
Fludarabine
Gemcitabine
Methotrexate (high-dose)
Nelarabine
Pemetrexed
Pentostatin
Pralatrexate
Raltitrexed
Tegafur-uracil (UFT)
Trifluridine/tipiracil
Checkpoint inhibitors · 16
Atezolizumab
Avelumab
Cemiplimab
Checkpoint inhibitors (pembrolizumab · nivolumab · ipilimumab)
Cosibelimab
Dostarlimab
Durvalumab
Ipilimumab
Nivolumab
Pembrolizumab
Penpulimab
Relatlimab
Retifanlimab
Sugemalimab
Tislelizumab
Toripalimab
Anti-angiogenic (VEGF) · 14
Axitinib
Bevacizumab
Cabozantinib
Fruquintinib
Lenvatinib
Nintedanib
Pazopanib
Ramucirumab
Regorafenib
Sunitinib
Tivozanib
Vandetanib
VEGFR TKIs (sunitinib · sorafenib · pazopanib · axitinib)
Ziv-aflibercept
Bispecifics / T-cell engagers · 14
Amivantamab
Blinatumomab
Catumaxomab
Elranatamab
Epcoritamab
Glofitamab
Ivonescimab
Linvoseltamab
Mosunetuzumab
Talquetamab
Tarlatamab
Tebentafusp
Teclistamab
Zanidatamab
Antibody-drug conjugates · 14
Belantamab mafodotin
Brentuximab vedotin
Datopotamab deruxtecan (Dato-DXd)
Enfortumab vedotin
Gemtuzumab ozogamicin
Inotuzumab ozogamicin
Loncastuximab tesirine
Mirvetuximab soravtansine
Polatuzumab vedotin
Sacituzumab govitecan
Telisotuzumab vedotin (Teliso-V)
Tisotumab vedotin
Trastuzumab deruxtecan
Trastuzumab emtansine (T-DM1)
Monoclonal antibodies (other) · 9
Daratumumab
Dinutuximab
Elotuzumab
Isatuximab
Mogamulizumab
Obinutuzumab
Rituximab
Tafasitamab
Zolbetuximab
Hormonal / endocrine · 8
Abiraterone
Bicalutamide
Darolutamide
Elacestrant
Enzalutamide
Lanreotide
Leuprolide
Octreotide
Antitumor antibiotics · 7
Bleomycin
Dactinomycin (actinomycin D)
Doxorubicin
Idarubicin
Mitomycin C
Mitoxantrone
Plicamycin (mithramycin)
Radiopharmaceuticals · 5
Lutetium-177 Dotatate
Lutetium-177 PSMA-617 (vipivotide)
Radium-223 dichloride
Samarium-153 lexidronam
Strontium-89 chloride
Platinum agents · 4
Carboplatin
Cisplatin
Nedaplatin
Oxaliplatin
CAR-T cell therapy · 4
CAR-T cell therapy
Ciltacabtagene autoleucel
Idecabtagene vicleucel
Obecabtagene autoleucel (Obe-cel)
Cytokines & enzymes · 4
Asparaginase
Interferon-α
Interleukin-2 (high-dose)
Pegaspargase
Bisphosphonates & bone · 4
Denosumab
Ibandronate
Pamidronate
Zoledronic acid

263 profiled agents × 14 injuries · tick = injury present · outlined tick = the agent's signature injury.

Figure 7·Every profiled agent as a row and the 14 kidney injuries as columns; grouped by class, the family-level injury signatures read at a glance.

Where each drug class strikes the nephron. Rows are class families, columns are nephron segments; a cell's depth of color is how many agents in that class target that segment. Read down a column for the agents converging on one structure, across a row for a class's anatomical footprint.

Glomerulus22
Vasculature / Endothelium129
Proximal Tubule58
Distal Tubule / Collecting Duct23
Interstitium22
Tubular Lumen8
Bladder / Urothelium1
Kinase inhibitors (TKIs)
4
34
22
10
Other targeted agents
2
35
9
3
2
Alkylating agents
4
7
5
4
1
1
Antimetabolites
11
4
2
Checkpoint inhibitors
16
Anti-angiogenic (VEGF)
11
3
Bispecifics / T-cell engagers
1
12
1
Antibody-drug conjugates
10
4
Monoclonal antibodies (other)
1
6
2
Hormonal / endocrine
3
4
1
Antitumor antibiotics
1
3
2
1
Radiopharmaceuticals
1
4
Platinum agents
4
CAR-T cell therapy
4
Cytokines & enzymes
1
3
Bisphosphonates & bone
1
2
1

Agent counts per class × nephron segment · color depth scales within the grid · column totals above each segment.

Figure 8·Agent counts per drug-class family × nephron segment — the anatomy of class-level renal risk in one grid.

Assemble a regimen and see where kidney risk compounds. Each bar is a kidney injury; its length is how many of the chosen agents carry it. Injuries struck by two or more drugs are the additive hazards to watch.

CisplatinGemcitabine
Acute Tubular Necrosis
1
Thrombotic Microangiopathy
1
Glomerular Injury / Proteinuria
1
Electrolyte Disturbance
1
Hypertension
1
Prerenal / Hemodynamic AKI
1

2 agents selected · bar segments = contributing drugs · ⚠ marks injuries hit by ≥2 agents (compounding risk). Educational — not a dosing tool.

Figure 9·An interactive regimen builder: for each kidney injury, how many chosen agents carry it — surfacing where combined risk compounds.

How the signature kidney injury shifts across drug generations. Each ribbon carries agents from an era (left) to their signature injury (right); width = number of agents. The established backbone sits in tubular injury while the frontier fans into thrombotic microangiopathy, interstitial nephritis, and glomerular disease.

Frontier → Acute Tubular Necrosis: 2 agentsRecent → Acute Tubular Necrosis: 4 agentsEstablished → Acute Tubular Necrosis: 5 agentsFrontier → Acute Interstitial Nephritis: 2 agentsEstablished → Acute Interstitial Nephritis: 4 agentsRecent → Acute Interstitial Nephritis: 6 agentsRecent → Thrombotic Microangiopathy: 1 agentsEstablished → Thrombotic Microangiopathy: 3 agentsFrontier → Glomerular Injury / Proteinuria: 1 agentsRecent → Glomerular Injury / Proteinuria: 1 agentsEstablished → Glomerular Injury / Proteinuria: 1 agentsRecent → Electrolyte Disturbance: 3 agentsEstablished → Electrolyte Disturbance: 8 agentsFrontier → Electrolyte Disturbance: 1 agentsRecent → Crystal / Obstructive Nephropathy: 1 agentsEstablished → Crystal / Obstructive Nephropathy: 2 agentsRecent → Hypertension: 4 agentsEstablished → Hypertension: 2 agentsRecent → Prerenal / Hemodynamic AKI: 18 agentsFrontier → Prerenal / Hemodynamic AKI: 16 agentsInvestigational → Prerenal / Hemodynamic AKI: 2 agentsEstablished → Prerenal / Hemodynamic AKI: 11 agentsFrontier → SIADH / Hyponatremia: 2 agentsRecent → SIADH / Hyponatremia: 1 agentsEstablished → SIADH / Hyponatremia: 2 agentsRecent → Pseudo-AKI: 7 agentsFrontier → Pseudo-AKI: 3 agentsEstablished → Pseudo-AKI: 1 agentsRecent → Chronic Interstitial Nephropathy: 1 agentsFrontier → Chronic Interstitial Nephropathy: 1 agentsEstablished → Chronic Interstitial Nephropathy: 2 agentsEstablished41Recent47Frontier28Investigational2Acute Tubular NecrosisAcute Interstitial NephritisThrombotic MicroangiopathyGlomerular Injury / ProteinuriaElectrolyte DisturbanceCrystal / Obstructive NephropathyHypertensionPrerenal / Hemodynamic AKISIADH / HyponatremiaPseudo-AKIChronic Interstitial Nephropathy

Ribbon width = agents flowing from each era to their signature injury · numbers = agents per era.

Figure 10·Agents flowing from their drug era to their signature kidney injury — the categorical companion to the evidence streamgraph.

Figures are derived from the static, citation-grounded catalog. FAERS is a spontaneous-reporting system — reporting odds ratios reflect disproportionate reporting, not incidence or proven causation. Medical-education content only — not medical advice.