期刊
AMERICAN JOURNAL OF KIDNEY DISEASES
卷 68, 期 2, 页码 287-291出版社
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1053/j.ajkd.2016.02.057
关键词
Programmed cell death 1; PD-1; PDCD1; anti-PD-1 antibody; PD-1 inhibitor; nivolumab; pembrolizumab; acute interstitial nephritis (AIN); acute kidney injury (AKI); non-small cell lung cancer (NSCLC); advanced melanoma; ipilimumab; immune checkpoint inhibitor; nephrotoxicity; renal biopsy
Immune checkpoint inhibitors that target the programmed death 1 (PD-1) signaling pathway have recently been approved for use in advanced pretreated non-small cell lung cancer and melanoma. Clinical trial data suggest that these drugs may have adverse effects on the kidney, but these effects have not been well described. We present 6 cases of acute kidney injury in patients with lung cancer who received anti-PD-1 antibodies, with each case displaying evidence of acute interstitial nephritis (AIN) on kidney biopsy. All patients were also treated with other drugs (proton pump inhibitors and nonsteroidal anti-inflammatory drugs) linked to AIN, but in most cases, use of these drugs long preceded PD-1 inhibitor therapy. The association of AIN with these drugs in our patients raises the possibility that PD-1 inhibitor therapy may release suppression of T-cell immunity that normally permits renal tolerance of drugs known to be associated with AIN. (C) 2016 by the National Kidney Foundation, Inc.
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