Immune checkpoint inhibitors and acute kidney injury

Ping Zhou; Ying Gao; Zhijuan Kong; Junlin Wang; Shuxuan Si; Wei Han; Jie Li; Zhimei Lv; Rong Wang

doi:10.3389/fimmu.2024.1353339

Immune checkpoint inhibitors and acute kidney injury

Front Immunol. 2024 Feb 23:15:1353339. doi: 10.3389/fimmu.2024.1353339. eCollection 2024.

Authors

Ping Zhou¹, Ying Gao², Zhijuan Kong², Junlin Wang², Shuxuan Si², Wei Han², Jie Li², Zhimei Lv^{1

2}, Rong Wang^{1

2}

Affiliations

¹ Department of Nephrology, Shandong Provincial Hospital, Shandong University, Jinan, China.
² Department of Nephrology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.

Abstract

As a new type of anti-tumor immunotherapy, immune checkpoint inhibitors (ICIs) have improved the prognosis of multiple malignancies. However, renal complications are becoming more frequent. Nephrotoxicity often manifests as acute kidney injury (AKI), and the most common histopathological type is acute tubulointerstitial nephritis (ATIN). Based on previous studies of the incidence and potential risk factors for nephrotoxicity, in this review, we describe the mechanism of AKI after ICIs treatment, summarize the incidence, risk factors, and outcomes of AKI, and discuss the diagnosis and management of immune checkpoint inhibitors-associated acute kidney injury (ICI-AKI). In addition, we review the current status of ICIs rechallenge and the therapeutic strategies of ICIs applied in kidney transplant recipients. Finally, we emphasize the importance of collaboration between nephrologists and oncologists to guide the treatment of ICIs and the management of renal complications.

Keywords: acute kidney injury; immune checkpoint inhibitors; immune-related adverse events; immunotherapy; malignancies; nephrotoxicity.

Publication types

Review
Research Support, Non-U.S. Gov't

MeSH terms

Acute Kidney Injury* / chemically induced
Acute Kidney Injury* / therapy
Humans
Immune Checkpoint Inhibitors / adverse effects
Immunotherapy / adverse effects
Kidney
Nephritis, Interstitial* / chemically induced

Substances

Immune Checkpoint Inhibitors

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This research was funded by National Natural Science Foundation of China (Grant: 81873615, 82070744, 81770723, 81400732), Academic promotion programme of Shandong First Medical University (NO: 2019QL022) and Taishan Scholars Program (NO: ts201712090, tsqn201812138)