Related Experiment Video

Updated: Sep 16, 2025

A Syngeneic Mouse Model of Metastatic Renal Cell Carcinoma for Quantitative and Longitudinal Assessment of Preclinical Therapies
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Immunotherapy-Associated Renal Dysfunction in Metastatic Cancer: An Emerging Challenge in Onco-Nephrology

Francesco Trevisani1, Andrea Angioi2, Michele Ghidini3

  • 1URI-Urological Research Institute, Department of Urology, Division of Experimental Oncology, IRCCS San Raffaele Hospital, Via Olgettina 60, 20132 Milan, Italy.

Cancers
|July 12, 2025
PubMed
Abstract

Insights

Acute kidney disease (AKD) is a common complication in patients receiving immune checkpoint inhibitors (ICIs). Early identification of high-risk patients is crucial for managing kidney health during cancer immunotherapy.

Area of Science:

  • Nephrology
  • Oncology
  • Immunology

Background:

  • Immune checkpoint inhibitors (ICIs) are vital in metastatic cancer treatment but pose nephrotoxic risks.
  • Acute kidney injury (AKI) is recognized, but the subacute phase, acute kidney disease (AKD), is understudied in ICI therapy.

Purpose of the Study:

  • To investigate the incidence and predictors of acute kidney disease (AKD) in patients undergoing immune checkpoint inhibitor (ICI) therapy.
  • To characterize the clinical course and risk factors associated with AKD in this patient population.

Main Methods:

  • Retrospective cohort study of 226 adult patients receiving ICIs.
  • AKD diagnosis based on 2024 Kidney Disease: Improving Global Outcomes (KDIGO) criteria.
  • Multivariable logistic regression identified AKD predictors.

Main Results:

  • AKD occurred in 20.4% of patients within 90 days of ICI initiation.
  • Higher body surface area and baseline NSAID use were independent AKD predictors (OR 8.17, OR 29.74).
  • A predictive model demonstrated good discrimination (AUC 0.778).

Conclusions:

  • Acute kidney disease (AKD) is a frequent, underrecognized complication of ICIs.
  • Identifying high-risk patients and implementing renal monitoring can improve safety and treatment.
  • AKD has implications for both renal function and cancer treatment outcomes.
Keywords:
acute kidney disease (AKD)acute kidney injury (AKI)cancerchronic kidney disease (CKD)immune checkpoint inhibitorsimmunotherapyonconephrology

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