[Immune check point inhibitor-associated renal toxicity]

Abstract

Immune checkpoint inhibition had a major clinical success in clinical oncology and impacted the treatment paradigm in many cancers. Immune related adverse events are well-described toxicities that are closely associated with CPI therapies and can involve any organ in the body. Renal toxicity is multifocal. In addition to the predominant tubulointerstitial involvement, immunotherapy can lead to a variety of glomerular damage and electrolyte disorders. Suggested mechanisms include direct renal interstitium lymphocyte infiltration, renal immune complex deposition, microangiopathic endothelial disease, or cytokine release leading to podocytopathy. Immunotherapy in the renal transplant patient raises the question of the rejection occurrence. Current recommendations for diagnosis and management of renal effects are not optimal because of the limited data available and understanding of their pathophysiology.

Keywords: Désordres hydroélectrolytiques; Electrolyte disorders; Glomerulopathy; Glomérulopathie; Immunotherapy; Immunothérapie; Insuffisance rénale; Interstitial nephritis; Néphrite interstitielle; Proteinuria; Protéinurie; Renal failure.