Chinese Journal of Nephrology, Dialysis & Transplantation
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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 ICIsinduced 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 offtarget kidney tissues,reactivation of drugspecific 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 ICIsinduced 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 ICIsinduced kidney injury,in order to improve management of this kind of complication and outcome of the patients.
REN Guisheng,HUANG Xianghua. The immune checkpoint inhibitors related kidney injury[J]. Chinese Journal of Nephrology, Dialysis & Transplantation, DOI: 10.3969/j.issn.1006-298X.2020.01.015.
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URL: http://www.njcndt.com/EN/10.3969/j.issn.1006-298X.2020.01.015
http://www.njcndt.com/EN/Y2020/V29/I1/71