A 48-year-old male patient with a history of uremia was diagnosed with pulmonary adenocarcinoma based on a computed tomography (CT) scan and biopsy. In addition, an epidermal growth factor receptor (EGFR) exon 19 deletion was identified by gene detection. Surgical treatment was not acceptable because of his poor physical condition, so he was treated with gefitinib. Kidney function deteriorated and the serum urea nitrogen and creatinine levels were increased. Two weeks after discontinuing treatment with gefitinib, kidney function gradually returned to normal and was treated with erlotinib. This is an unusual case involving a patient with EGFR-mutated pulmonary adenocarcinoma and a history of uremia who was successfully treated with erlotinib after gefitinib-induced kidney dysfunction.