[非小细胞肺癌化疗和免疫检查点抑制剂致急性肾损伤1例报告]。

Zhonghua nei ke za zhi Pub Date : 2023-05-01 DOI:10.3760/cma.j.cn112138-20220520-00392

X F Zheng, Y C Dong, Q Bian

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[Acute kidney injury caused by chemotherapy and immune checkpoint inhibitors in non-small cell lung cancer: a case report].

患者男性，67岁。因肺腺癌行卡铂-培美曲塞方案化疗，联合免疫检查点抑制剂（ICIs）治疗肿瘤2个疗程后血肌酐252 μmol/L，肾组织活检病理提示急性肾小管坏死合并局灶性急性间质性肾炎，肾间质和肾小管淋巴细胞CD4浸润强阳性，程序性死亡受体1（PD-1）阳性，考虑为化疗药联合ICIs相关肾损伤。停用化疗及免疫治疗，予患者口服甲泼尼龙20 mg/d治疗4周后，规律减量至第9周停药，复查血肌酐98 μmol/L。恢复卡铂-培美曲塞联合化疗，后续培美曲塞单药化疗维持。肾组织活检是明确诊断及指导后续治疗的重要手段。.

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