Oncology has seen a rapid expansion in the use of targeted therapy directed against cancer-specific molecules and signaling pathways. Tyrosine kinases are an especially important target because they play an important role in the modulation of growth factor signaling. Examples of tyrosine kinase inhibitors (TKI) are sunitinib, sorafenib, axitinib, and pazopanib. These not only inhibit VEGF, but also have inhibitory activity against other receptor tyrosine kinases, such as the platelet-derived growth factor receptor or cKit. However, a number of renal specific side effects are increasing being recognized. These include thrombotic microangiopathy, acute and chronic interstitial nephritis, and hypophosphatemia.