Research progress on immune checkpoint inhibitors related kidney injury
10.3760/cma.j.cn101721-20230710-000242
- VernacularTitle:免疫检查点抑制剂相关肾损伤研究进展
- Author:
Chengcheng GE
1
;
Lijie GU
Author Information
1. 上海交通大学医学院附属第六人民医院超声医学科，上海 200080
- Keywords:
Immune checkpoint inhibitors;
Immune-related adverse event;
Nephrotoxicity;
Acute kidney injury
- From:
Clinical Medicine of China
2024;40(4):316-320
- CountryChina
- Language:Chinese
-
Abstract:
Immune checkpoint inhibitors (ICIs) are an important method for cancer treatment today, including programmed cell death receptor 1 (PD-1), programmed cell death ligand 1 (PD-L1), and cytotoxic T lymphocyte antigen 4 (CTLA-4) inhibitors. It has achieved unprecedented benefits in various malignant tumors, but its adverse reactions deserve attention. The enhanced immune response induced by these drugs can lead to immune related adverse events (irAEs), which have a significant impact on drug use and patient prognosis. It can occur in any system throughout the body, and ICI associated acute kidney injury (ICI-AKI) is one of them. The mechanisms include loss of tolerance to autoantigens, reactivation of drug specific effector T cells, and production of kidney specific autoantibodies. The most common pathological manifestation is acute tubulointerstitial nephritis, with only a few cases of ICIs related glomerulonephritis reported. ICI-AKI usually responds well to early corticosteroid treatment, and most patients can achieve complete or partial remission. We provide a review of the epidemiology, pathogenesis, clinical manifestations, diagnostic methods, and management strategies of ICI-AKI, with a focus on exploring its risk factors, reactivation of ICIs, and prognosis. This will help to adopt management measures to reduce the occurrence of ICI-AKI and improve the prognosis of tumor patients.
