Extensive ¹⁷⁷Lu-PSMA Radioligand Therapy Can Lead to Radiation Nephropathy with a Renal Thrombotic Microangiopathy-like Picture

Lutetium-177 prostate-specific membrane antigen (177Lu-PSMA) radioligand ther-apy is an option that is increasingly being used for treatment of metastatic castration-resistant prostate cancer. This delivers b-radiation to cells expressing PSMA and high accumulation of the radiopharmaceutical occurs in the kidneys. Here we report three cases of radiation nephropathy with severe chronic kidney disease induced by renal thrombotic microangiopathy following extensive treat-ment with 177Lu-PSMA radioligand therapy. (c) 2022 European Association of Urology. Published by Elsevier B.V. All rights reserved.