대한신장학회

Skip Navigation: Skip to contents

KOR
ENG
전체메뉴보기

간행물 검색

현재 페이지 경로

HOME
간행물
간행물 검색

논문분류	춘계학술대회 초록집
제목	Optimizing Management of Immune Checkpoint Inhibitor-Induced Renal Events: The Role of Kidney Biopsies
저자	Sojung Youn
출판정보	2024; 2024(1):
키워드
초록	Objectives: This study aimed to investigate renal adverse events (AEs), such as acute kidney injury (AKI) and proteinuria, in patients treated with immune checkpoint inhibitors (ICIs), examining clinical characteristics and kidney biopsy findings using the Catholic Medical Center-Clinical Data Warehouse (CMC-CDW). Methods: Clinical, laboratory data and kidney biopsy results from 70 patients across 8 university hospitals, who underwent kidney biopsies between January 1, 2012, and October 23, 2022, after ICI therapy, were analyzed. Results: Of these, 7 patients experienced ICI-related renal AEs, with 5 undergoing biopsies for AKI (1 for Grade 2 toxicity and 4 for Grade 3 toxicity as defined by the American Society of Clinical Oncology practice guidelines) and 2 for nephrotic range proteinuria. The ICIs used included Pembrolizumab (4 patients), Blinatumomab, Ramucirumab, and Afatinib. The average time to biopsy post-therapy initiation was 8.3 months. Biopsy results showed acute tubulointerstitial nephritis in 5 patients (one with concurrent IgM nephropathy), mild acute tubular necrosis, and membranous glomerulonephritis. Treatment involved steroids (oral prednisolone 30mg to intravenous methylprednisolone 125mg) and cessation of the causative ICI for patients with AKI. Those with proteinuria received oral prednisolone or angiotensin receptor blockers, without discontinuing ICI therapy. All patients showed good responses, returning to baseline kidney function or proteinuria levels. Conclusions: The study concludes that ICI-related renal AEs, notably severe AKI, can necessitate halting or ending immunotherapy, impacting treatment options and outcomes. Therefore, quick and accurate diagnosis, guided by kidney biopsy, is crucial for managing these AEs and determining the continuation or adjustment of cancer treatments for patients with limited alternatives.
원문(PDF)	PDF 원문보기

목록

위로가기