关键词: 免疫检查点抑制剂, 肾损伤

Abstract: Immune checkpoint inhibitors(ICIS) have been approved in the treatment of a series of malignant tumors,and kidney injury is an uncommon adverse reaction of this breakthrough innovation,which affects the prognosis of  patients significantly.The mechanisms underlying ICIsinduced kidney injury may include development of autoantibodies that are pathogenic to the kidney,induction of  immune reaction against the tissues which express checkpoint receptors,formation of new or reactivated T cells against tumor antigens that crossreact with offtarget kidney tissues,reactivation of drugspecific T cells through ICIs induced loss of tolerance and over expression of proinflammatory cytokines.Acute kidney injury without oliguria or hypertension is the most common clinical manifestation of ICIsinduced kidney injury,and acute tubular interstitial injury is the major pathological changes.However,a variety of glomerular lesions can be observed,together with a different degree of urinarl abnormality.Kidney biopsy is helpful in confirm  etiology of the kidney injury of patients receiving ICIs,and whether  therapy should be discontinued.The usage of glucocorticoids depend on the graduation of acute kidney injury.In this review,we will discuss mechanisms, clinical manifestations, pathological changes and treatment strategy of ICIsinduced kidney injury,in order to improve management of this kind of complication and outcome of the patients.