Renal Tubular Acidosis and Immune Checkpoint Inhibitor Therapy: An Immune-Related Adverse Event of PD-1 Inhibitor-A Report of 3 Cases

Sandra M Herrmann; Mariam P Alexander; Michael F Romero; Ladan Zand

doi:10.1016/j.xkme.2020.05.015

Renal Tubular Acidosis and Immune Checkpoint Inhibitor Therapy: An Immune-Related Adverse Event of PD-1 Inhibitor-A Report of 3 Cases

Kidney Med. 2020 Aug 11;2(5):657-662. doi: 10.1016/j.xkme.2020.05.015. eCollection 2020 Sep-Oct.

Authors

Sandra M Herrmann¹, Mariam P Alexander², Michael F Romero^{1

3}, Ladan Zand¹

Affiliations

¹ Divisions of Nephrology and Hypertension, Mayo Clinic, Rochester, MN.
² Anatomic Pathology, Mayo Clinic, Rochester, MN.
³ Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN.

Abstract

The main cause of acute kidney injury in patients receiving immune checkpoint inhibitors (ICIs) is acute interstitial nephritis. However, as their use continues to increase, other kidney manifestations are being described. We report 3 cases of patients treated with ICIs who developed predominantly electrolyte disorders secondary to renal tubular acidosis as an immune-related adverse event and discuss the potential mechanism. Nongap acidosis in combination with hypokalemia should raise suspicion for distal renal tubular acidosis in patients treated with ICIs.

Keywords: Immune checkpoint inhibitors; PD-1 inhibitor; acute interstitial nephritis; case report; immune-related adverse event; renal tubular acidosis.

Publication types

Case Reports

Abstract

Publication types

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