TY - JOUR
T1 - Diagnosis and management of immune checkpoint inhibitor–associated nephrotoxicity
T2 - a position statement from the American Society of Onco-nephrology
AU - Herrmann, Sandra M.
AU - Abudayyeh, Ala
AU - Gupta, Shruti
AU - Gudsoorkar, Prakash
AU - Klomjit, Nattawat
AU - Motwani, Shveta S.
AU - Karam, Sabine
AU - Costa E Silva, Verônica T.
AU - Khalid, Sheikh B.
AU - Anand, Shuchi
AU - Kala, Jaya
AU - Leaf, David E.
AU - Murakami, Naoka
AU - Rashidi, Arash
AU - Wanchoo, Rimda
AU - Kitchlu, Abhijat
N1 - Publisher Copyright:
© 2024 International Society of Nephrology
PY - 2025/1
Y1 - 2025/1
N2 - Immune checkpoint inhibitors (ICIs) have revolutionized the treatment of cancer and are now the backbone of therapy for several malignancies. However, ICIs can cause a spectrum of kidney immune-related adverse events including acute kidney injury (AKI), most commonly manifesting as acute interstitial nephritis (AIN), although glomerular disease and electrolyte disturbances have also been reported. In this position statement by the American Society of Onco-nephrology (ASON), we summarize the incidence and risk factors for ICI-AKI, pathophysiological mechanisms, and clinicopathologic features of ICI-AKI. We also discuss novel diagnostic approaches and promising biomarkers for ICI-AKI. From expert panel consensus, we provide clinical practice points for the initial assessment and diagnosis of ICI-AKI, management and immunosuppressive therapy, and consideration for rechallenge with ICI following AKI episodes. In addition, we explore ICI use in special populations, such as kidney transplant recipients, and propose key areas of focus for future research and clinical investigation.
AB - Immune checkpoint inhibitors (ICIs) have revolutionized the treatment of cancer and are now the backbone of therapy for several malignancies. However, ICIs can cause a spectrum of kidney immune-related adverse events including acute kidney injury (AKI), most commonly manifesting as acute interstitial nephritis (AIN), although glomerular disease and electrolyte disturbances have also been reported. In this position statement by the American Society of Onco-nephrology (ASON), we summarize the incidence and risk factors for ICI-AKI, pathophysiological mechanisms, and clinicopathologic features of ICI-AKI. We also discuss novel diagnostic approaches and promising biomarkers for ICI-AKI. From expert panel consensus, we provide clinical practice points for the initial assessment and diagnosis of ICI-AKI, management and immunosuppressive therapy, and consideration for rechallenge with ICI following AKI episodes. In addition, we explore ICI use in special populations, such as kidney transplant recipients, and propose key areas of focus for future research and clinical investigation.
KW - acute interstitial nephritis
KW - acute kidney injury
KW - immune checkpoint inhibitors
KW - immune-related adverse event
UR - http://www.scopus.com/inward/record.url?scp=85212573061&partnerID=8YFLogxK
U2 - 10.1016/j.kint.2024.09.017
DO - 10.1016/j.kint.2024.09.017
M3 - Article
C2 - 39455026
AN - SCOPUS:85212573061
SN - 0085-2538
VL - 107
SP - 21
EP - 32
JO - Kidney International
JF - Kidney International
IS - 1
ER -