Abstract: A 36year old young man treated with gemcitabine and paclitaxel for half a year after the diagnosis of pancreatic cancer, presented with bilateral lower extremities edema, oliguria and hypertention.Laboratory examinations showed severe proteinuria and elevated serum creatinine. Renal biopsy revealed thrombotic microangiopathy. The final diagnosis was gemcitabine related kidney impairment.

Key words: pancreatic cancer, Gemcitabine, thrombotic microangiopathy, renal biopsy