{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T17:02:20Z","timestamp":1777914140550,"version":"3.51.4"},"reference-count":61,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2022,5,24]],"date-time":"2022-05-24T00:00:00Z","timestamp":1653350400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Toxicol Pathol"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:p>Drug-induced kidney injury has historically been associated with renal tubule injury related to small molecule pharmaceuticals such as nonsteroidal anti-inflammatory drugs, antineoplastic agents, or antibiotics, but as a greater number of alternative classes of medicines such as biotherapeutics, molecular-targeted antineoplastic drugs, chimeric antigen receptor T-cell therapies, antibody-drug conjugates, oligonucleotide therapies, or other immunomodulatory drugs come to market, the presentation of drug-induced nephrotoxicity is changing. This review article describes the potential rare clinical events in drug-induced kidney injury that might be noted with these new therapies and their potential impact on patients. Potential pathogenic mechanisms related to immunogenicity, immune complex formation, and stimulation of downstream proinflammatory pathways with some of these alternative medicine classes have resulted in the potential for glomerulonephritis, acute interstitial nephritis, renal vasculitis, and other immune-mediated renal disorders in humans. This contrasts with nonclinical toxicity studies, where biologic therapies more often result in vasculitis and glomerulonephritis associated with antidrug antibodies and immunomodulatory pharmacology, and which are not always predictive of clinical effects. While nonclinical antidrug antibody-related renal disease is generally not clinically relevant, other immune-mediated nephrotoxicities associated with immunomodulatory drugs may be predictive of clinical adverse events. Fortunately, these conditions are still rare and account for a small percentage of serious adverse events in kidneys of patients.<\/jats:p>","DOI":"10.1177\/01926233221100414","type":"journal-article","created":{"date-parts":[[2022,5,24]],"date-time":"2022-05-24T05:20:43Z","timestamp":1653369643000},"page":"408-414","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Kidney Effects by Alternative Classes of Medicines in Patients and Relationship to Effects in Nonclinical Toxicity Studies"],"prefix":"10.1177","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4608-5543","authenticated-orcid":false,"given":"Kendall S.","family":"Frazier","sequence":"first","affiliation":[{"name":"Private Consultant, Alligator Point, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2022,5,24]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12882-017-0536-3"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.semnephrol.2018.12.007"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejmech.2021.113284"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2014.05.005"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/0192623318789399"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40259-021-00467-w"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/0192623314526475"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/0192623315570340"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/0192623317723539"},{"key":"e_1_3_2_11_2","first-page":"569","volume-title":"Toxicologic Pathology: Preclinical Safety Assessment","author":"Frazier KS","unstructured":"Frazier KS, Seely JC. Urinary system. In: Sahota PS, Popp JA, Hardisty JF, Gopinath C, eds. Toxicologic Pathology: Preclinical Safety Assessment. 2nd ed. Boca Raton, FL: CRC Press\/Taylor & Francis Pub; 2018:569-638.","edition":"2"},{"issue":"6","key":"e_1_3_2_12_2","first-page":"718","article-title":"Biologics-induced kidney injury -with special attention to anti-rheumatic drugs","volume":"64","author":"Kimura H","year":"2016","unstructured":"Kimura H. Biologics-induced kidney injury -with special attention to anti-rheumatic drugs. Rinsho Byori. 2016;64(6):718-722.","journal-title":"Rinsho Byori"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40259-017-0231-8"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2020.00312"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.01910215"},{"issue":"4","key":"e_1_3_2_16_2","first-page":"397","article-title":"Secondary membranous nephropathy\u2014one center experience","volume":"27","author":"Rihova Z","year":"2005","unstructured":"Rihova Z, Honsova E, Merta M, et al. Secondary membranous nephropathy\u2014one center experience. Ren Fail. 2005;27(4):397-402.","journal-title":"Ren Fail"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1080\/14740338.2017.1372421"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfh832"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0b013e3181441a68"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1517\/14740338.2015.995089"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02786470"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.molimm.2020.10.015"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-016-2289-y"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1517\/14712598.2012.646984"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.8828"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1172\/JCI151697"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.seminoncol.2017.06.007"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2018-0764"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfy100"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.34067\/KID.0000152019"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40425-018-0478-8"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2016.07.026"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.171.11.6251"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1158\/2326-6066.CIR-14-0040"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0161779"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1706169"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2020.02.012"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2019.10.011"},{"key":"e_1_3_2_39_2","volume-title":"Handbook of Toxicologic Pathology","author":"Frazier KS","year":"2022","unstructured":"Frazier KS, Scicchitano MS, Heinz-Taheny K, Cianciolo R. Kidney. In: Haschek WM, Rousseaux CG, Wallig MA, eds. Handbook of Toxicologic Pathology. 4th ed. Vol. 4. Academic Press; 2022 (accepted 2022; anticipated publishing date 2023).","edition":"4"},{"key":"e_1_3_2_40_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11523-015-0368-7"},{"key":"e_1_3_2_41_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41379-018-0186-4"},{"key":"e_1_3_2_42_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ekir.2016.09.055"},{"key":"e_1_3_2_43_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2021.08.022"},{"issue":"12","key":"e_1_3_2_44_2","first-page":"8675","article-title":"Mechanism of kidney injury caused by bevacizumab in rats","volume":"7","author":"Zhao N","year":"2014","unstructured":"Zhao N, Xu Q, Wang M, et al. Mechanism of kidney injury caused by bevacizumab in rats. Int J Clin Exp Pathol. 2014;7(12):8675-8683.","journal-title":"Int J Clin Exp Pathol"},{"key":"e_1_3_2_45_2","doi-asserted-by":"publisher","DOI":"10.2174\/1871520614666140127105809"},{"key":"e_1_3_2_46_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13361-015-1103-4"},{"key":"e_1_3_2_47_2","doi-asserted-by":"publisher","DOI":"10.3390\/cancers13205036"},{"key":"e_1_3_2_48_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(19)30788-0"},{"key":"e_1_3_2_49_2","doi-asserted-by":"publisher","DOI":"10.2147\/DDDT.S267404"},{"key":"e_1_3_2_50_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40265-017-0705-5"},{"key":"e_1_3_2_51_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmet.2018.03.004"},{"key":"e_1_3_2_52_2","doi-asserted-by":"publisher","DOI":"10.1021\/jacs.0c12043"},{"key":"e_1_3_2_53_2","doi-asserted-by":"publisher","DOI":"10.1186\/s11658-019-0196-3"},{"key":"e_1_3_2_54_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-018-02989-4"},{"key":"e_1_3_2_55_2","doi-asserted-by":"publisher","DOI":"10.1177\/01926233211011615"},{"key":"e_1_3_2_56_2","first-page":"78","article-title":"Antisense oligonucleotides: the promise and the challenges from the toxicologic pathologist\u2019s perspective. Toxicol","volume":"43","author":"Frazier KS","year":"2015","unstructured":"Frazier KS. Antisense oligonucleotides: the promise and the challenges from the toxicologic pathologist\u2019s perspective. Toxicol. Pathol. 2015;43:78-79.","journal-title":"Pathol"},{"key":"e_1_3_2_57_2","doi-asserted-by":"publisher","DOI":"10.1177\/0192623315570341"},{"key":"e_1_3_2_58_2","doi-asserted-by":"publisher","DOI":"10.1089\/nat.2015.0598"},{"key":"e_1_3_2_59_2","doi-asserted-by":"publisher","DOI":"10.1177\/0192623313505781"},{"key":"e_1_3_2_60_2","doi-asserted-by":"publisher","DOI":"10.1089\/nat.2017.0693"},{"key":"e_1_3_2_61_2","doi-asserted-by":"publisher","DOI":"10.1124\/jpet.116.233809"},{"key":"e_1_3_2_62_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.drudis.2017.01.013"}],"container-title":["Toxicologic Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/01926233221100414","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/01926233221100414","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/01926233221100414","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T16:42:44Z","timestamp":1777653764000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/01926233221100414"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,24]]},"references-count":61,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2022,6]]}},"alternative-id":["10.1177\/01926233221100414"],"URL":"https:\/\/doi.org\/10.1177\/01926233221100414","relation":{},"ISSN":["0192-6233","1533-1601"],"issn-type":[{"value":"0192-6233","type":"print"},{"value":"1533-1601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5,24]]}}}