Table 3 Comparison of the characteristics and renal outcomes of patients with CPI related nephropathy between the current study and the previously published case reports
Case | Renal Manifestation | Urine studies/ Serology | Malignancy | Immunotherapy | Therapy | Response |
|---|---|---|---|---|---|---|
Nephrotic syndrome cases in relation to immune checkpoint agents | ||||||
Daanen et al. [13] | FSGS | – | RCC | Nivolumab | D/C + steroids+ MMF | Remission followed by relapse |
Kitchlu et al. [14] | MCD | – | Hodgkin lymphoma | Pembrolizumab | D/C + steroids | Remission (partial) |
Kitchlu et al. [14] | MCD | – | Melanoma | Ipilimumab | D/C + steroids | Remission |
Lin et al. [9] | Membranous Nephropathy (PLA2R neg.) | – | Melanoma | Nivolumab | D/C + steroids | Remission (partial) |
Current study (#11) | Membranous Nephropathy (PLA2R neg.) | – | RCC | Nivolumab | D/C + steroids | Remission |
IgA nephropathy cases in relation to immune checkpoint agents | ||||||
Jung et al. [16] | AKI grade 4 Cellular crescents with necrosis Sub-epithelial desposition. | Proteinuria and hematuria | Clear cell Kidney cancer | Nivolumab | D/C, steroids and RRT | Recovery (RRT was d/c after 5 months) |
Kishi et al. [15] | AKI grade 2 Mesangial exp. with no crescents or endocapillary hypercellularity | Sub nephrotic proteinuria. Hematuria | Lung SCC | Nivolumab | D/C | Remission (Complete) |
Current study (#9) | AKI grade 2 endocapillary hypercellularity | Nephrotic range proteinuria Pyuria and hematuria | Melanoma | Nivolumab+ Ipilimumab | D/C and steroids | Remission followed by relapse |
Current study (#10) | AKI grade 3 No Glomerular proliferative lesions* | No proteinuria No hematuria +pyuria | Melanoma | Pembrolizumab | D/C and steroids, MMF, and infliximab | Partial recovery |
Pauci-immune GN cases in relation to immune checkpoint agents | ||||||
Van den Brom et al. [12] | GPA ** Dysmorphic erythrocytes and proteinuria Extra renal: Cutaneous vasculitis Stable lung nodule | +PR3-ANCA C; normal | Malignant Melanoma | Ipilimumab followed by Pembrolizumab | Cyclosporine and steroids | Remission |
Cusnir et al. [10] | GPA Focal proliferative GN Extra renal; Cutaneous vasculitis sinusitis | +PR3-ANCA C; N/A | Malignant Melanoma | Nivolumab+ Ipilimumab | steroids and rituximab | Not Stated |
Current study (#6) | Focal necrotizing pauci-immune glomerulonephritis with no crescents Extra renal; N/A | Negative ANCA C; N/A G3 | NSCLC (SCC) | Nivolumab | D/C, steroids and rituximab | Complete recovery |
Current study (#7) | Focal segmental pauci-immune necrotizing glomerulonephritis Extra renal; N/A | +MPO-ANCA C; normal G3 | mRCC | Tremelimumab | D/C, steroids, plasmaphresis and rituximab | Partial recovery |
Current study (#8) | Granulomatous necrotizing vasculitis Extra renal; N/A | Negative ANCA C3/4 normal | Uveal Melanoma | Nivolumab+ Ipilimumab | D/C, steroids and rituximab | Complete recovery |
Anti-dsDNA cases in relation to immune checkpoint agents | ||||||
Fadel et al. [11] | AKI with proteinuria Extramembranous and mesangial deposits (IgG, IgM, C3, C1q) | +dsDNA C; normal | Metastatic Melanoma | Ipilimumab | D/C | Partial renal recovery dsNDA; not detectable |
Current study (#2) | AKI with proteinuria ATIN with no I.C. deposition GN | +dsDNA and RNP | Bladder cancer | Nivolumab | D/C and steroids | Partial renal recovery dsNDA and RNP; not detectable |