The DOI matches its Crossref record; 10 of the 10 references it cites were found in a registry or an index.
Clinicopathological features of acute kidney injury associated with immune checkpoint inhibitors
Open accessAbstract
Immune checkpoint inhibitors (CPIs), monoclonal antibodies that target inhibitory receptors expressed on T cells, represent an emerging class of immunotherapy used in treating solid organ and hematologic malignancies. We describe the clinical and histologic features of 13 patients with CPI-induced acute kidney injury (AKI) who underwent kidney biopsy. Median time from initiation of a CPI to AKI was 91 (range, 21 to 245) days. Pyuria was present in 8 patients, and the median urine protein to creatinine ratio was 0.48 (range, 0.12 to 0.98) g/g. An extra-renal immune-related adverse event occurred prior to the onset of AKI in 7 patients. Median peak serum creatinine was 4.5 (interquartile range, 3.6-7.3) mg/dl with 4 patients requiring hemodialysis. The prevalent pathologic lesion was acute tubulointerstitial nephritis in 12 patients, with 3 having granulomatous features, and one thrombotic microangiopathy. Among the 12 patients with acute tubulointerstitial nephritis, 10 received treatment with glucocorticoids, resulting in complete or partial improvement in renal function in 2 and 7 patients, respectively. However, the two patients with acute tubulointerstitial nephritis not given glucocorticoids had no improvement in renal function. Thus, CPI-induced AKI is a new entity that presents with clinical and histologic features similar to other causes of drug-induced acute tubulointerstitial nephritis, though with a longer latency period. Glucocorticoids appear to be a potentially effective treatment strategy. Hence, AKI due to CPIs may be caused by a unique mechanism of action linked to reprogramming of the immune system, leading to loss of tolerance.
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Cites
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BackgroundAcute interstitial nephritis: clinical features and response to corticosteroid therapy
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Cited by
Brahmer, J. R., Lacchetti, C., Schneider, B. J., Atkins, M. B., Brassil, K. J., Caterino, J. M., Chau, I., Ernstoff, M. S., Gardner, J. M., Ginex, P., et al. (2018) · Journal of Clinical Oncology · doi:10.1200/jco.2017.77.6385 · Cited by 3,713
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“In one series of patients who were biopsied after developing acute kidney injury while on ICPis an acute tubulo-interstitial nephritis with lymphocytic infiltration was the most frequent finding [79].”
BackgroundAdverse effects of immune-checkpoint inhibitors: epidemiology, management and surveillance
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on behalf of the Society for Immunotherapy of Cancer Toxicity Management Working Group, Puzanov, I., Diab, A., Abdallah, K., Bingham, C. O., Brogdon, C., Dadu, R., Hamad, L., Kim, S., Lacouture, M. E., et al. (2017) · Journal for ImmunoTherapy of Cancer · doi:10.1186/s40425-017-0300-z · Cited by 1,992
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Self-citation
Metadata
- Authors
- Cortazar, F. B., Marrone, K. A., Troxell, M. L., Ralto, K. M., Hoenig, M. P., Brahmer, J. R., Le, D. T., Lipson, E. J., Glezerman, I. G., Wolchok, J., Cornell, L. D., Feldman, P., Stokes, M. B., Zapata, S. A., Hodi, F. S., Ott, P. A., Yamashita, M., & Leaf, D. E.
- Venue
- Kidney International
- Publisher
- Elsevier BV
- Published
- 2016-09
- Volume
- 90
- Issue
- 3
- Pages
- 638-647
- ISSN
- 0085-2538 (ISSN-L)
- OpenAlex
- W2413514895
- Cited by
- 650
- References
- 10
- FWCI
- 25.50
- Type
- journal article
- Language
- en
- Open access
- bronze
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