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Am J Kidney Dis. 2016 Aug;68(2):287-291. doi: 10.1053/j.ajkd.2016.02.057. Epub 2016 Apr 22.

Association of Acute Interstitial Nephritis With Programmed Cell Death 1 Inhibitor Therapy in Lung Cancer Patients.

Author information

1
Section of Nephrology, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT. Electronic address: anushree.shirali@yale.edu.
2
Section of Nephrology, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT.
3
Section of Oncology, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT.

Abstract

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.

KEYWORDS:

PD-1; PD-1 inhibitor; PDCD1; Programmed cell death 1; acute interstitial nephritis (AIN); acute kidney injury (AKI); advanced melanoma; anti–PD-1 antibody; immune checkpoint inhibitor; ipilimumab; nephrotoxicity; nivolumab; non-small cell lung cancer (NSCLC); pembrolizumab; renal biopsy

PMID:
27113507
DOI:
10.1053/j.ajkd.2016.02.057
[Indexed for MEDLINE]

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