Login to MyKarger

New to MyKarger? Click here to sign up.



Login with Facebook

Forgot your password?

Authors, Editors, Reviewers

For Manuscript Submission, Check or Review Login please go to Submission Websites List.

Submission Websites List

Institutional Login
(Shibboleth or Open Athens)

For the academic login, please select your country in the dropdown list. You will be redirected to verify your credentials.

In-Depth Topic Review

A Karger OLA/Global Kidney Academy Blog article
-- Free Access

Adverse Renal Effects of Immune Checkpoint Inhibitors: A Narrative Review

Wanchoo R.a · Karam S.c · Uppal N.N.a · Barta V.S.a · Deray G.d · Devoe C.b · Launay-Vacher V.d, e · Jhaveri K.D.a · on behalf of Cancer and Kidney International Network Workgroup on Immune Checkpoint Inhibitors

Author affiliations

aDivision of Kidney Diseases and Hypertension, Hofstra Northwell School of Medicine, Great Neck, and bDivision of Hematology and Oncology, Hofstra Northwell School of Medicine and Northwell Cancer Institute, New Hyde Park, USA; cDepartment of Medicine, University of Balamand, Faculty of Medicine, Beirut, Lebanon; dNephrology Department, Pitié-Salpêtrière University Hospital, and eService ICAR, Pitié-Salpêtrière University Hospital, Paris, France

Corresponding Author

Kenar D. Jhaveri, MD

Professor of Medicine, Nephrology, Northwell Health

Hofstra Northwell School of Medicine

Great Neck, NY 11021 (USA)

E-Mail kjhaveri@northwell.edu

Related Articles for ""

Am J Nephrol 2017;45:160-169

Do you have an account?

Login Information





Contact Information










I have read the Karger Terms and Conditions and agree.



Abstract

Background: Cancer immunotherapy, such as anti-cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) and anti-programmed death 1 (PD-1), has revolutionized the treatment of malignancies by engaging the patient's own immune system against the tumor rather than targeting the cancer directly. These therapies have demonstrated a significant benefit in the treatment of melanomas and other cancers. Summary: In order to provide an extensive overview of the renal toxicities induced by these agents, a Medline search was conducted of published literature related to ipilimumab-, pembrolizumab-, and nivolumab-induced kidney toxicity. In addition, primary data from the initial clinical trials of these agents and the FDA adverse reporting system database were also reviewed to determine renal adverse events. Acute interstitial nephritis (AIN), podocytopathy, and hyponatremia were toxicities caused by ipilimumab. The main adverse effect associated with both the PD-1 inhibitors was AIN. The onset of kidney injury seen with PD-1 inhibitors is usually late (3-10 months) compared to CTLA-4 antagonists related renal injury, which happens earlier (2-3 months). PD-1 as opposed to CTLA-4 inhibitors has been associated with kidney rejection in transplantation. Steroids appear to be effective in treating the immune-related adverse effects noted with these agents. Key Message: Although initially thought to be rare, the incidence rates of renal toxicities might be higher (9.9-29%) as identified by recent studies. As a result, obtaining knowledge about renal toxicities of immune checkpoint inhibitors is extremely important.

© 2017 S. Karger AG, Basel


Article / Publication Details

First-Page Preview
Abstract of In-Depth Topic Review

Published online: January 12, 2017
Issue release date: February 2017

Number of Print Pages: 10
Number of Figures: 3
Number of Tables: 2

ISSN: 0250-8095 (Print)
eISSN: 1421-9670 (Online)

For additional information: http://www.karger.com/AJN


Copyright / Drug Dosage / Disclaimer

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.