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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

From: Nephrotoxicity of immune checkpoint inhibitors beyond tubulointerstitial nephritis: single-center experience

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
  1. FSGS focal segemental glomerulosclerosis, MCD mininmal change disease, D/C immune checkpoint agent was discontinued, Neg Negative, PLA2R anti-phospholipase-A2 receptor, AKI acute kidney injury, I.C immune complex, GN glomerulonephritis, C, complement, Exp. expansion, AKI acute kidney injury, ATIN acute tubulointerstitial nephritis, RRT renal replacement therapy, GPA granulomatosis with polyangiitis, PR3 proteinase 3, ANCA antineutrophil cytoplasmic antibodies, MPO myeloperoxidase, N/A not available, NSCLC non-small cell lung cancer, mRCC metastatic renal cell carcinoma, dsDNA double stranded DNA
  2. *Renal biospy was done 5 weeks post treatment with steroid, MMF and infliximab
  3. **Presumptive diagnosis. Renal Biopsy was not reported