Acute interstitial nephritis related to immune checkpoint inhibitors

被引：72

作者：

Belliere, Julie ^{[1
]}

Meyer, Nicolas ^{[2
,3
,4
]}

Mazieres, Julien ^{[4
,5
]}

Ollier, Sylvie ^{[6
]}

Boulinguez, Serge ^{[2
]}

Delas, Audrey ^{[7
]}

Ribes, David ^{[1
]}

Faguer, Stanislas ^{[1
,4
,8
]}

机构：

[1] Hop Rangueil, Ctr Reference Malad Renales Rares, Dept Nephrol & Transplantat Organes, Toulouse, France

[2] Inst Univ Canc Toulouse Oncopole, Serv Dermatol Oncol, Toulouse, France

[3] INSERM UMR 1037 CRCT, Toulouse, France

[4] Univ Toulouse 3, Toulouse, France

[5] Hop Larrey, Serv Pneumol, Toulouse, France

[6] Inst Univ Canc Toulouse Oncopole, Serv Med Interne & Immunol Clin, Toulouse, France

[7] Inst Univ Canc Toulouse Oncopole, Lab Anatomopathol, Toulouse, France

[8] INSERM U1048, Equipe Fibrose Renale 12, Inst Malad Metabol & Cardiovasc, Toulouse, France

来源：

BRITISH JOURNAL OF CANCER | 2016年 / 115卷 / 12期

关键词：

immune checkpoint inhibitors; acute interstitial nephritis; PD-1; acute kidney injury; IPILIMUMAB; ANTIBODY; CANCER;

D O I：

10.1038/bjc.2016.358

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background: Immune checkpoint inhibitors (anti-PD1 or anti-CTLA-4) are increasingly used in various cancers. Immune checkpoint inhibitors (ICI)-related renal disorders are poorly described (9 cases) and were only related to Ipilimumab. Methods: Retrospective collection of clinical charts of all the patients admitted for renal disorders following ICI in the University Hospital of Toulouse (France). Results: We report on adverse renal events that occurred in three patients treated with anti-PD1 (nivolumab or pembrolizumab) or anti-CTLA-4 (ipilimumab). Acute kidney injury occurred at 4-12 weeks after initiation of treatment, and harbored features of tubulo-interstitial nephritis (interstitial polymorphic inflammatory infiltrate with predominant CD3+ CD4+ T cells, associated with granuloma in one). Following withdrawal of ICI and steroid intake, estimated glomerular-filtration rate had improved in all patients. Conclusions: These data suggest that all ICI can lead to acute interstitial nephritis, possibly related to the presence of autoreactive clonal T cells. We recommend that patients receiving ICI should undergo renal monitoring every 2 weeks for 3-6 months.

引用

页码：1457 / 1461

页数：5

共 13 条

[1] Clinicopathological features of acute kidney injury associated with immune checkpoint inhibitors [J].