VEGF is essential for maintaining the integrity of the capillary and arteriole network, especially at the delicate capillary-podocyte interface.45,46 Monoclonal antibodies that inhibit VEGF and VEGFR inhibitors are associated with thrombotic microangiopathy, proteinuria, and CKD.47,48 Putative mechanisms for EGFR inhibitors, CDK4/6 inhibitors, and BRAF inhibitors nephrotoxicity are less clear. This evidence concerns the gene CDK4 and Genetic thrombotic microangiopathy.