Nephrotic syndrome with acute kidney injury due to combination therapy of immune checkpoint inhibitors: a case report and review of the literature
Abstract Background Recent studies have focused on immune checkpoint inhibitors. Renal complications associated with the use of immune checkpoint inhibitors are uncommon compared with other immune-related adverse events. Acute interstitial nephritis accounts for most of these renal complications, wi...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-02-01
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| Series: | BMC Nephrology |
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| Online Access: | https://doi.org/10.1186/s12882-024-03494-1 |
| _version_ | 1797275546440171520 |
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| author | Ryosuke Saiki Kan Katayama Haruko Saiki Ayumi Fukumori Kayo Tsujimoto Masahiro Yamawaki Fumika Tanaka Daisuke Takahashi Keiko Oda Yasuo Suzuki Tomohiro Murata Kaoru Dohi |
| author_facet | Ryosuke Saiki Kan Katayama Haruko Saiki Ayumi Fukumori Kayo Tsujimoto Masahiro Yamawaki Fumika Tanaka Daisuke Takahashi Keiko Oda Yasuo Suzuki Tomohiro Murata Kaoru Dohi |
| author_sort | Ryosuke Saiki |
| collection | DOAJ |
| description | Abstract Background Recent studies have focused on immune checkpoint inhibitors. Renal complications associated with the use of immune checkpoint inhibitors are uncommon compared with other immune-related adverse events. Acute interstitial nephritis accounts for most of these renal complications, with nephrotic syndrome quite rare. We herein report a case of nephrotic syndrome associated with immune checkpoint inhibitors that was more severe than that in previous cases. By comparing this case with previous reports, the possible reasons for the particular severity of this case are discussed. Case presentation A 75-year-old man developed nephrotic syndrome with acute kidney injury after the first combination therapy of nivolumab and ipilimumab for malignant pleural mesothelioma. The results of a kidney biopsy indicated minimal change disease with mild atherosclerosis, acute interstitial nephritis, and fusion of nearly all podocyte foot processes. Nivolumab and ipilimumab therapy were stopped, and treatment with corticosteroids was initiated. We investigated previously reported cases of nephrotic syndrome using immune checkpoint inhibitors. Seventeen cases of immune checkpoint inhibitor-related nephrotic syndrome, including ours, have been reported. Two of the 17 patients with immune checkpoint inhibitor-related nephrotic syndrome required hemodialysis treatment for acute kidney injury. Unlike many previously reported cases, the present patient was administered two different immune checkpoint inhibitors, which may be one of the reasons for the development of severe nephrotic syndrome. Conclusions In addition to previously reported risk factors, immune checkpoint inhibitor combination therapy can exacerbate nephrotic syndrome compared to immune checkpoint inhibitor monotherapy. |
| first_indexed | 2024-03-07T15:14:58Z |
| format | Article |
| id | doaj.art-59291dfa7ab74ae6968c72831f86950e |
| institution | Directory Open Access Journal |
| issn | 1471-2369 |
| language | English |
| last_indexed | 2024-03-07T15:14:58Z |
| publishDate | 2024-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Nephrology |
| spelling | doaj.art-59291dfa7ab74ae6968c72831f86950e2024-03-05T17:57:05ZengBMCBMC Nephrology1471-23692024-02-012511610.1186/s12882-024-03494-1Nephrotic syndrome with acute kidney injury due to combination therapy of immune checkpoint inhibitors: a case report and review of the literatureRyosuke Saiki0Kan Katayama1Haruko Saiki2Ayumi Fukumori3Kayo Tsujimoto4Masahiro Yamawaki5Fumika Tanaka6Daisuke Takahashi7Keiko Oda8Yasuo Suzuki9Tomohiro Murata10Kaoru Dohi11Department of Cardiology and Nephrology, Mie University Graduate School of MedicineDepartment of Cardiology and Nephrology, Mie University Graduate School of MedicineDepartment of Pulmonary and Critical Care Medicine, Faculty and Graduate School of Medicine, Mie UniversityDepartment of Cardiology and Nephrology, Mie University Graduate School of MedicineDepartment of Cardiology and Nephrology, Mie University Graduate School of MedicineDepartment of Cardiology and Nephrology, Mie University Graduate School of MedicineDepartment of Cardiology and Nephrology, Mie University Graduate School of MedicineDepartment of Cardiology and Nephrology, Mie University Graduate School of MedicineDepartment of Cardiology and Nephrology, Mie University Graduate School of MedicineDepartment of Cardiology and Nephrology, Mie University Graduate School of MedicineDepartment of Cardiology and Nephrology, Mie University Graduate School of MedicineDepartment of Cardiology and Nephrology, Mie University Graduate School of MedicineAbstract Background Recent studies have focused on immune checkpoint inhibitors. Renal complications associated with the use of immune checkpoint inhibitors are uncommon compared with other immune-related adverse events. Acute interstitial nephritis accounts for most of these renal complications, with nephrotic syndrome quite rare. We herein report a case of nephrotic syndrome associated with immune checkpoint inhibitors that was more severe than that in previous cases. By comparing this case with previous reports, the possible reasons for the particular severity of this case are discussed. Case presentation A 75-year-old man developed nephrotic syndrome with acute kidney injury after the first combination therapy of nivolumab and ipilimumab for malignant pleural mesothelioma. The results of a kidney biopsy indicated minimal change disease with mild atherosclerosis, acute interstitial nephritis, and fusion of nearly all podocyte foot processes. Nivolumab and ipilimumab therapy were stopped, and treatment with corticosteroids was initiated. We investigated previously reported cases of nephrotic syndrome using immune checkpoint inhibitors. Seventeen cases of immune checkpoint inhibitor-related nephrotic syndrome, including ours, have been reported. Two of the 17 patients with immune checkpoint inhibitor-related nephrotic syndrome required hemodialysis treatment for acute kidney injury. Unlike many previously reported cases, the present patient was administered two different immune checkpoint inhibitors, which may be one of the reasons for the development of severe nephrotic syndrome. Conclusions In addition to previously reported risk factors, immune checkpoint inhibitor combination therapy can exacerbate nephrotic syndrome compared to immune checkpoint inhibitor monotherapy.https://doi.org/10.1186/s12882-024-03494-1Nivolumab– ipilimumabImmune checkpoint inhibitorsNephrotic syndromeAcute kidney injuryMinimal change disease |
| spellingShingle | Ryosuke Saiki Kan Katayama Haruko Saiki Ayumi Fukumori Kayo Tsujimoto Masahiro Yamawaki Fumika Tanaka Daisuke Takahashi Keiko Oda Yasuo Suzuki Tomohiro Murata Kaoru Dohi Nephrotic syndrome with acute kidney injury due to combination therapy of immune checkpoint inhibitors: a case report and review of the literature BMC Nephrology Nivolumab– ipilimumab Immune checkpoint inhibitors Nephrotic syndrome Acute kidney injury Minimal change disease |
| title | Nephrotic syndrome with acute kidney injury due to combination therapy of immune checkpoint inhibitors: a case report and review of the literature |
| title_full | Nephrotic syndrome with acute kidney injury due to combination therapy of immune checkpoint inhibitors: a case report and review of the literature |
| title_fullStr | Nephrotic syndrome with acute kidney injury due to combination therapy of immune checkpoint inhibitors: a case report and review of the literature |
| title_full_unstemmed | Nephrotic syndrome with acute kidney injury due to combination therapy of immune checkpoint inhibitors: a case report and review of the literature |
| title_short | Nephrotic syndrome with acute kidney injury due to combination therapy of immune checkpoint inhibitors: a case report and review of the literature |
| title_sort | nephrotic syndrome with acute kidney injury due to combination therapy of immune checkpoint inhibitors a case report and review of the literature |
| topic | Nivolumab– ipilimumab Immune checkpoint inhibitors Nephrotic syndrome Acute kidney injury Minimal change disease |
| url | https://doi.org/10.1186/s12882-024-03494-1 |
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