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Biomedicines
Volume 13
Issue 3
10.3390/biomedicines13030711
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Background:
Systematic Review

Nephrotoxicity of Immune Checkpoint Inhibitors in Single and Combination Therapy—A Systematic and Critical Review

by
Javier Tascón
1,2,3,4,
Alfredo G. Casanova
1,2,3,4,
Laura Vicente-Vicente
1,2,3,4,
Francisco J. López-Hernández
2,3,4,5 and
Ana I. Morales
1,2,3,4,5,*
1
Toxicology Unit, Universidad de Salamanca (USAL), 37007 Salamanca, Spain
2
Instituto de Investigación Biomédica de Salamanca (IBSAL), 37007 Salamanca, Spain
3
Department of Physiology and Pharmacology, Universidad de Salamanca (USAL), 37007 Salamanca, Spain
4
Group of Translational Research on Renal and Cardiovascular Diseases (TRECARD), 37007 Salamanca, Spain
5
Group of Biomedical Research on Critical Care (BioCritic), 47005 Valladolid, Spain
*
Author to whom correspondence should be addressed.
Biomedicines 2025, 13(3), 711; https://doi.org/10.3390/biomedicines13030711
Submission received: 8 January 2025 / Revised: 5 March 2025 / Accepted: 10 March 2025 / Published: 13 March 2025
(This article belongs to the Special Issue The Development of Cancer Immunotherapy)
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Abstract

Background/Objectives: Immune checkpoint inhibitors (ICIs) have generated a revolutionary approach in the treatment of cancer, but their effectiveness has been compromised by immune-related adverse events, including renal damage. Although rare, these effects are relevant because they have been related to poor patient prognoses. The objective of this review was to estimate the current incidence of nephrotoxicity in patients treated with single and double ICI therapies. Methods: A total of 1283 potential articles were identified, which were reduced to 50 after applying the exclusion and inclusion criteria. Results: This study reveals the increase in acute kidney injury associated with these drugs in the last decade and shows that, interestingly, combined therapies with ICIs does not lead to an increase in kidney damage compared with anti-CTLA-4. It also suggests that kidney damage could be underdiagnosed when it comes to interstitial nephritis, because definitive evidence requires a renal biopsy. Conclusions: In perspective, these conclusions could guide clinicians in making decisions for therapy personalization and highlight the need to search for new diagnostic systems that are more sensitive and specific to the type of damage and could replace the biopsy.
Keywords: immune checkpoint inhibitors (ICIs); acute kidney injury; tubulointerstitial nephritis; nephrotoxicity; systematic review; cancer immune checkpoint inhibitors (ICIs); acute kidney injury; tubulointerstitial nephritis; nephrotoxicity; systematic review; cancer

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MDPI and ACS Style

Tascón, J.; Casanova, A.G.; Vicente-Vicente, L.; López-Hernández, F.J.; Morales, A.I. Nephrotoxicity of Immune Checkpoint Inhibitors in Single and Combination Therapy—A Systematic and Critical Review. Biomedicines 2025, 13, 711. https://doi.org/10.3390/biomedicines13030711

AMA Style

Tascón J, Casanova AG, Vicente-Vicente L, López-Hernández FJ, Morales AI. Nephrotoxicity of Immune Checkpoint Inhibitors in Single and Combination Therapy—A Systematic and Critical Review. Biomedicines. 2025; 13(3):711. https://doi.org/10.3390/biomedicines13030711

Chicago/Turabian Style

Tascón, Javier, Alfredo G. Casanova, Laura Vicente-Vicente, Francisco J. López-Hernández, and Ana I. Morales. 2025. "Nephrotoxicity of Immune Checkpoint Inhibitors in Single and Combination Therapy—A Systematic and Critical Review" Biomedicines 13, no. 3: 711. https://doi.org/10.3390/biomedicines13030711

APA Style

Tascón, J., Casanova, A. G., Vicente-Vicente, L., López-Hernández, F. J., & Morales, A. I. (2025). Nephrotoxicity of Immune Checkpoint Inhibitors in Single and Combination Therapy—A Systematic and Critical Review. Biomedicines, 13(3), 711. https://doi.org/10.3390/biomedicines13030711

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