{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T15:56:48Z","timestamp":1789055808761,"version":"build-2803163510"},"reference-count":65,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2021,6,30]],"date-time":"2021-06-30T00:00:00Z","timestamp":1625011200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Immune checkpoint inhibitors (ICI) targeting CTLA-4 and the PD-1\/PD-L1 axis have unprecedentedly improved global prognosis in several types of cancers. However, they are associated with the occurrence of immune-related adverse events. Despite their low incidence, renal complications can interfere with the oncologic strategy. The breaking of peripheral tolerance and the emergence of auto- or drug-reactive T-cells are the main pathophysiological hypotheses to explain renal complications after ICI exposure. ICIs can induce a large spectrum of renal symptoms with variable severity (from isolated electrolyte disorders to dialysis-dependent acute kidney injury (AKI)) and presentation (acute tubule-interstitial nephritis in &gt;90% of cases and a minority of glomerular diseases). In this review, the current trends in diagnosis and treatment strategies are summarized. The diagnosis of ICI-related renal complications requires special steps to avoid confounding factors, identify known risk factors (lower baseline estimated glomerular filtration rate, proton pump inhibitor use, and combination ICI therapy), and prove ICI causality, even after long-term exposure (weeks to months). A kidney biopsy should be performed as soon as possible. The treatment strategies rely on ICI discontinuation as well as co-medications, corticosteroids for 2 months, and tailored immunosuppressive drugs when renal response is not achieved.<\/jats:p>","DOI":"10.3390\/diagnostics11071187","type":"journal-article","created":{"date-parts":[[2021,6,30]],"date-time":"2021-06-30T03:53:15Z","timestamp":1625025195000},"page":"1187","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Renal Complications Related to Checkpoint Inhibitors: Diagnostic and Therapeutic Strategies"],"prefix":"10.3390","volume":"11","author":[{"given":"Julie","family":"Belliere","sequence":"first","affiliation":[{"name":"Department of Nephrology and Organ Transplantation, University Hospital of Toulouse, 31 400 Toulouse, France"},{"name":"INSERM U1048 (Institute of Metabolic and Cardiovascular Diseases), 31 400 Toulouse, France"},{"name":"Department of Biological Sciences, Paul Sabatier University, 31 400 Toulouse, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julien","family":"Mazieres","sequence":"additional","affiliation":[{"name":"Department of Biological Sciences, Paul Sabatier University, 31 400 Toulouse, France"},{"name":"Institut Universitaire du Cancer Toulouse Oncopole, 31 400 Toulouse, France"},{"name":"Department of Pneumology, University Hospital of Toulouse, 31 400 Toulouse, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Meyer","sequence":"additional","affiliation":[{"name":"Department of Biological Sciences, Paul Sabatier University, 31 400 Toulouse, France"},{"name":"Institut Universitaire du Cancer Toulouse Oncopole, 31 400 Toulouse, France"},{"name":"Department of Dermatology, University Hospital of Toulouse, 31 400 Toulouse, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leila","family":"Chebane","sequence":"additional","affiliation":[{"name":"Service Pharmacologie M\u00e9dicale et Clinique, Centre Midi-Pyr\u00e9n\u00e9es de PharmacoVigilance, de Pharmaco\u00e9pid\u00e9miologie et d\u2019Informations sur le M\u00e9dicament, 31 400 Toulouse, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabien","family":"Despas","sequence":"additional","affiliation":[{"name":"Service Pharmacologie M\u00e9dicale et Clinique, Centre Midi-Pyr\u00e9n\u00e9es de PharmacoVigilance, de Pharmaco\u00e9pid\u00e9miologie et d\u2019Informations sur le M\u00e9dicament, 31 400 Toulouse, France"},{"name":"Service de Pharmacologie M\u00e9dicale et Clinique, Facult\u00e9 de M\u00e9decine, Universit\u00e9 Paul Sabatier, Equipe PEPSS Centre d\u2019Investigation Clinique 1436, INSERM 1297, 31 400 Toulouse, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,6,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1002\/rmv.1733","article-title":"Effect of maintenance immunosuppressive drugs on virus pathobiology: Evidence and potential mechanisms","volume":"23","author":"Brennan","year":"2013","journal-title":"Rev. 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