Manohar Sandhya, Jhaveri Kenar D, Perazella Mark A
Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN.
Division of Kidney Diseases and Hypertension, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Great Neck, NY.
Adv Chronic Kidney Dis. 2021 Sep;28(5):429-437.e1. doi: 10.1053/j.ackd.2021.07.006.
Nephrotoxicity associated with immunotherapy is increasingly being encountered in clinical practice. Drugs that augment the immune system to eradicate cancer are revolutionary in the field of oncology. Older generation immunotherapies such as high-dose interleukin and interferon-alpha are now being replaced with more effective immune checkpoint inhibitors and chimeric antigen receptor T-cell therapies, which have shown promising results in numerous clinical trials. Unfortunately, these treatments come with a unique baggage of adverse effects including nephrotoxicity. This onconephrology review summarizes the immunotherapies currently in use and their kidney-related toxicities, pathophysiology, and their management.
免疫疗法相关的肾毒性在临床实践中越来越常见。增强免疫系统以根除癌症的药物在肿瘤学领域具有革命性意义。高剂量白细胞介素和α干扰素等老一代免疫疗法如今正被更有效的免疫检查点抑制剂和嵌合抗原受体T细胞疗法所取代,这些疗法在众多临床试验中已显示出令人鼓舞的结果。不幸的是,这些治疗伴随着包括肾毒性在内的一系列独特的不良反应。这篇肿瘤肾脏病学综述总结了目前正在使用的免疫疗法及其与肾脏相关的毒性、病理生理学和管理方法。