Acute Tubulointerstitial Nephritis in Clinical Oncology: A Comprehensive Review.

Area of Science:

• Nephrology
• Oncology
• Immunology

Background:

• Acute kidney injury (AKI) is a frequent complication in patients with malignancy.
• Acute tubulointerstitial nephritis (ATIN) is a significant cause of AKI in cancer patients, necessitating awareness among oncologists and nephrologists.
• ATIN is characterized by tubulointerstitial inflammation involving T lymphocytes and other immune cells.

Purpose of the Study:

• To provide a comprehensive review of the differential diagnosis of ATIN in patients with cancer.
• To highlight the various causes of ATIN in the context of malignancy, including drug-induced, infection-related, and malignancy-associated ATIN.

Main Methods:

• Literature review focusing on ATIN in cancer patients.
• Analysis of existing data on the causes and mechanisms of ATIN.
• Synthesis of information regarding differential diagnosis strategies.

Main Results:

• Drug-related ATIN, particularly associated with antineoplastic treatments and novel immunotherapies, is a major cause.
• Infections and pathogen antigens can trigger ATIN in immunosuppressed cancer patients.
• Hematological malignancies themselves can present with ATIN, sometimes at disease onset.

Conclusions:

• ATIN is a critical consideration in the differential diagnosis of AKI in cancer patients.
• Understanding the diverse etiologies of ATIN is crucial for timely and effective management.
• Further research into the specific mechanisms and diagnostic approaches for ATIN in this population is warranted.