Acute Kidney Injury Associated with Novel Anti-Cancer Therapies: Immunotherapy.

Abstract

Abstract: The landscape of cancer survival has been positively affected by the introduction and dissemination of immunotherapy with the wide usage of immune checkpoint inhibitors (ICIs) and chimeric antigen receptors cell therapies (CAR-T). The success of these novel therapies can however be limited to a certain extent by systemic inflammatory toxicities affecting directly or indirectly the kidney. In the case of ICIs severe acute interstitial nephritis is the main adverse event and can lead to permanent discontinuation of the therapy. In turn, CAR-T cell therapy can cause cytokine release syndrome (CRS) and immune effector cell-associated hemophagocytic lympho-histiocytosis (IEC-HLH), with kidney damage through various mechanisms and be life-threatening. Prompt diagnosis and management of these entities is essential to preserve kidney function and ensure the best possible kidney and overall outcomes to cancer patients.