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(2) Methods: We comprehensively searched PubMed, Embase, Web of Science, and Cochrane for case reports, case series, and cohort studies for patients with biopsy-proven kidney IRAEs. All data were used to describe pathological characteristics and outcomes, and individual-level data from case reports and case series were pooled to analyze risk factors associated with different pathologies and prognoses. (3) Results: In total, 384 patients from 127 studies were enrolled. Most patients were treated with PD-1\/PD-L1 inhibitors (76%), and 95% presented with acute kidney disease (AKD). Acute tubulointerstitial nephritis\/acute interstitial nephritis (ATIN\/AIN) was the most common pathologic type (72%). Most patients (89%) received steroid therapy, and 14% (42\/292) required RRT. Among AKD patients, 17% (48\/287) had no kidney recovery. Analyses of pooled individual-level data from 221 patients revealed that male sex, older age, and proton pump inhibitor (PPI) exposure were associated with ICI-associated ATIN\/AIN. Patients with glomerular injury had an increased risk of tumor progression (OR 2.975; 95% CI, 1.176, 7.527; p = 0.021), and ATIN\/AIN posed a decreased risk of death (OR 0.164; 95% CI, 0.057, 0.473; p = 0.001). (4) Conclusions: We provide the first systematic review of biopsy-proven ICI-kidney IRAEs of interest to clinicians. Oncologists and nephrologists should consider obtaining a kidney biopsy when clinically indicated.<\/jats:p>","DOI":"10.3390\/jcm12041349","type":"journal-article","created":{"date-parts":[[2023,2,8]],"date-time":"2023-02-08T04:21:59Z","timestamp":1675830119000},"page":"1349","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Clinicopathological Features of Kidney Injury Related to Immune Checkpoint Inhibitors: A Systematic Review"],"prefix":"10.3390","volume":"12","author":[{"given":"Ling-Yi","family":"Xu","sequence":"first","affiliation":[{"name":"Renal Division, Department of Medicine, Institute of Nephrology, Peking University First Hospital, Peking University, Beijing 100034, China"},{"name":"Renal Pathology Center, Institute of Nephrology, Peking University First Hospital, Beijing 100034, China"},{"name":"Key Laboratory of Renal Disease, Ministry of Health of China, Beijing 100034, China"},{"name":"Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Beijing 100034, China"},{"name":"Research Units of Diagnosis and Treatment of Immune-Mediated Kidney Diseases, Chinese Academy of Medical Sciences, Beijing 100034, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9036-6978","authenticated-orcid":false,"given":"Hai-Ya","family":"Zhao","sequence":"additional","affiliation":[{"name":"Renal Division, Department of Medicine, Institute of Nephrology, Peking University First Hospital, Peking University, Beijing 100034, China"},{"name":"Renal Pathology Center, Institute of Nephrology, Peking University First Hospital, Beijing 100034, China"},{"name":"Key Laboratory of Renal Disease, Ministry of Health of China, Beijing 100034, China"},{"name":"Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Beijing 100034, China"},{"name":"Research Units of Diagnosis and Treatment of Immune-Mediated 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