Fruquintinib raised the risk of proteinuria and severe hypertension across four randomised trials

The edition in brief

A meta-analysis of four randomised trials with 1,872 patients with gastrointestinal cancers found fruquintinib, a VEGF receptor inhibitor, increased grade 3 or higher hypertension about ninefold (RR 9.01) and any-grade proteinuria (RR 1.89), supporting blood pressure optimisation and routine urinalysis before and during treatment. In a randomised factorial trial of 108 women aged 40 to 77 doing resistance training with 0.8, 1.6 or 2.2 g/kg/day protein for 12 weeks, urea, creatinine and cystatin C rose and eGFR estimates fell, mainly between the lowest and higher intakes; the authors caution that this does not establish kidney injury. A meta-analysis of 36 studies with 4,530 renal masses, published in April, found contrast-enhanced ultrasound had 94% sensitivity and 85% specificity for malignancy, with higher sensitivity for cystic masses. A single-cell study of deceased and living donor kidneys identified donor and recipient immune cell programmes associated with delayed graft function.