PDF(Pubmed)
Abstract：
As a new type of anti-tumor immunotherapy, immune checkpoint inhibitors (ICIs) have improved the prognosis of multiple malignancies. However, renal complications are becoming more frequent. Nephrotoxicity often manifests as acute kidney injury (AKI), and the most common histopathological type is acute tubulointerstitial nephritis (ATIN). Based on previous studies of the incidence and potential risk factors for nephrotoxicity, in this review, we describe the mechanism of AKI after ICIs treatment, summarize the incidence, risk factors, and outcomes of AKI, and discuss the diagnosis and management of immune checkpoint inhibitors-associated acute kidney injury (ICI-AKI). In addition, we review the current status of ICIs rechallenge and the therapeutic strategies of ICIs applied in kidney transplant recipients. Finally, we emphasize the importance of collaboration between nephrologists and oncologists to guide the treatment of ICIs and the management of renal complications.
摘要：
作为一种新型的抗肿瘤免疫疗法,免疫检查点抑制剂(ICIs)改善了多种恶性肿瘤的预后.然而,肾脏并发症越来越频繁。肾毒性通常表现为急性肾损伤（AKI），最常见的组织病理学类型是急性肾小管间质性肾炎（ATIN）。基于先前对肾毒性的发生率和潜在危险因素的研究，在这次审查中,我们描述了ICIs治疗后AKI的机制，总结发病率，危险因素，和AKI的结果，并讨论免疫检查点抑制剂相关急性肾损伤（ICI-AKI）的诊断和治疗。此外,我们回顾了ICIs再激发的现状以及ICIs在肾移植受者中应用的治疗策略.最后,我们强调肾脏病学家和肿瘤学家合作指导ICIs治疗和肾脏并发症管理的重要性.
