Pembrolizumab-related renal toxicities: diagnosis first, treatment later

Checkpoint inhibitors are increasingly used to treat different types of malignancy and have been associated with renal toxicities. In this issue, Izzedine et al. report on the incidence of pembrolizumab-associated renal toxicity in a French single-centre nephrology referral centre. They report an estimated incidence of pembrolizumab-related renal toxicities of 1.77% and most notably the most common histologic lesion was acute tubular injury (not acute tubulo-interstitial nephritis). This study further highlights the importance of performing a thorough nephrological workup including kidney biopsy in patients experiencing renal toxicities while receiving pembrolizumab treatment.