• 1.

    Gupta S, et al. Acute kidney injury in patients treated with immune checkpoint inhibitors. J Immunother Cancer 2021; 9:e003467. doi: 10.1136/jitc-2021-003467

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 2.

    Gupta S, et al. Immune checkpoint inhibitor nephrotoxicity: Update 2020. Kidney360 2020; 1:130140. https://kidney360.asnjournals.org/content/1/2/130

  • 3.

    Brahmer JR, et al. Society for Immunotherapy of Cancer (SITC) clinical practice guideline on immune checkpoint inhibitor-related adverse events. J Immunother Cancer 2021; 9:e002435. doi: 10.1136/jitc-2021-002435

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 4.

    Kitchlu A, et al. A systematic review of immune checkpoint inhibitor-associated glomerular disease. Kidney Int Rep 2021; 6:6677. doi: 10.1016/j.ekir.2020.10.002

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 5.

    Uppal NN, et al. Electrolyte and acid-base disorders associated with cancer immunotherapy. Clin J Am Soc Nephrol [Published online ahead of print January 21, 2022]. doi: 10.2215/CJN.14671121; https://cjasn.asnjournals.org/content/early/2022/02/06/CJN.14671121

    • Search Google Scholar
    • Export Citation
  • 6.

    Wanchoo R, et al. Immune checkpoint inhibitor-associated electrolyte disorders: Query of the Food and Drug Administration Adverse Event Reporting System. Kidney Int 2021; 100:945947. doi: 10.1016/j.kint.2021.06.001

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 7.

    Seethapathy H, et al. Hyponatremia and other electrolyte abnormalities in patients receiving immune checkpoint inhibitors. Nephrol Dial Transplant 2021; 36:22412247. doi: 10.1093/ndt/gfaa272

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 8.

    Manohar S, et al. Programmed cell death protein 1 inhibitor treatment is associated with acute kidney injury and hypocalcemia: Meta-analysis. Nephrol Dial Transplant 2019; 34:108117. doi: 10.1093/ndt/gfy105

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 9.

    Vogel WV., et al. Ipilimumab-induced sarcoidosis in a patient with metastatic melanoma undergoing complete remission. J Clin Oncol 2012; 30:e7e10. doi: 10.1200/JCO.2011.37.9693

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 10.

    Mills TA, et al. Parathyroid hormone-related peptide-linked hypercalcemia in a melanoma patient treated with ipilimumab: Hormone source and clinical and metabolic correlates. Semin Oncol 2015; 42:909914. doi: 10.1053/j.seminoncol.2015.09.006

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 11.

    Chalan P, et al. Thyroid dysfunctions secondary to cancer immunotherapy. J Endocrinol Invest 2018; 41:625638. doi: 10.1007/s40618-017-0778-8

  • 12.

    Ferris RL, et al. Nivolumab for recurrent squamous-cell carcinoma of the head and neck. N Engl J Med 2016; 375:18561867. doi: 10.1056/nejmoa1602252

Immune Checkpoint Inhibitors and the Kidney: An Update

  • 1 Shruti Gupta, MD, MPH, is Director of Onco-Nephrology at Brigham and Women's Hospital (BWH) and Dana-Farber Cancer Institute and an Associate Physician in the Division of Renal Medicine, BWH, Boston, MA. Paul E. Hanna, MD, MSc, is a clinical research fellow at Massachusetts General Hospital, Boston.
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Immune checkpoint inhibitors (ICPis) have transformed the landscape of oncology, and they are now approved for the treatment of over one dozen different types of cancer. ICPis block immune checkpoints—the “brakes” of the immune system—and therefore activate cytotoxic T-cells to eliminate cancer cells. However, enhancement of T-cell activity also leads to autoimmune toxicities or immune-related adverse events (irAEs), which can affect multiple organ systems, including the kidneys. ICPi-associated acute kidney injury (ICPi-AKI) can have major repercussions, including discontinuation from therapy and prolonged courses of immunosuppression.

Recently, Gupta et al. (1) conducted a multicenter study of 429 cases of

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