Epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs), as vital targeted therapies in cancer treatment, show significant clinical effectiveness but raise increasing safety concerns. Current safety studies mainly focus on dermatologic, hepatic, and pulmonary toxicities.1 The common toxicities of EGFR-TKIs (e.g., rash, diarrhea, interstitial lung disease) are more noticeable and often reported, so they have traditionally received more attention in clinical trials and guidelines; this has somewhat overshadowed renal adverse reactions, which are less common or more subtle. Moreover, early signs of nephrotoxicity are mostly non-specific; additionally, cancer patients often have pre-existing kidney disease or are on other nephrotoxic chemotherapies, making nephrotoxicity challenging to diagnose accurately. Furthermore, initial EGFR-TKI trials primarily focused on efficacy outcomes, with limited follow-up and no specific renal function monitoring included in the protocols, resulting in inadequate data on the incidence and characteristics of nephrotoxicity.