Department of Nephrology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
Department of Respiratory and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
Asia Pac J Clin Oncol. 2020 Dec;16(6):305-311. doi: 10.1111/ajco.13387. Epub 2020 Jun 23.
The status of immune checkpoint inhibitors (ICPIs) is raising in the treatment of malignancy for their effectiveness. The ICPIs therapy takes the risk of off-target toxicity because of immune system overactivation, including renal toxicity. It was declared that the renal toxicity was rare. However, with the increasing experience of ICPIs therapy, the renal immune-relate adverse events of ICPIs were reported more and their management was launching an enthusiastic discussion nowadays. In this review, we focused on the mechanism of ICPIs related renal irAEs (immune-related adverse events), the clinical and pathological manifestation of different forms of renal injury, and management strategies when the renal irAEs happened. Good management of irAEs might need help from Multi-Disciplinary Treatment and could promote a better clinical practice on ICPIs.
免疫检查点抑制剂（ICPI）在恶性肿瘤治疗中的地位因其疗效而不断提高。由于免疫系统过度激活，包括肾毒性，ICPI 治疗存在脱靶毒性的风险。此前曾宣称肾毒性罕见。然而，随着 ICPIs 治疗经验的增加，现在更多地报道了 ICPIs 相关的肾免疫相关不良事件，其管理也正在引发热烈讨论。在这篇综述中，我们重点关注了 ICPIs 相关肾免疫相关不良事件（irAEs）的机制、不同形式肾损伤的临床和病理表现，以及发生肾 irAEs 时的管理策略。irAEs 的良好管理可能需要多学科治疗的帮助，并能促进 ICPIs 的更好临床实践。
