Full
Outline
Immune checkpoint inhibitors (ICPis), a kind of monoclonal antibodies that target inhibitory receptors expressed on T cells, represent an emerging class of immunotherapy used in treating solid organ and hematologic malignancies. Unfortunately, ICPis have also been associated with the emergence of a new subsets of autoimmune-like toxicities, known as immune-related adverse events (irAEs). Acute kidney injury (AKI) is one of the common irAEs. This paper reviews the clinical manifestations, incidence, risk factors, mechanisms and treatment of ICPi-induced AKI. The risk of ICPi-induced AKI is significantly higher than that induced by chemotherapeutic drugs, and the involved risk factors include the type of ICPi drug and the proton pump inhibitors (PPIs). The typical symptom of ICPi-induced AKI is increased serum levels of creatinine and pyuria. The typical histopathological features are acute tubulointerstitial nephritis (ATIN). During ICPi treatment, renal function should be closely monitored to detect and intervene AKI early. The main treatment is glucocorticoid therapy, and immunosuppressive drugs can be added when necessary. This study provides reference for the clinical safety application of ICPi in China with a view to improve the prognosis of cancer patients and make them more beneficial.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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