A new expression of immune checkpoint inhibitors' renal toxicity: when distal tubular acidosis precedes creatinine elevation

Xavier Charmetant; Cécile Teuma; Jennifer Lake; Frédérique Dijoud; Vincent Frochot; Abbas Deeb

doi:10.1093/ckj/sfz051

A new expression of immune checkpoint inhibitors' renal toxicity: when distal tubular acidosis precedes creatinine elevation

Clin Kidney J. 2019 May 14;13(1):42-45. doi: 10.1093/ckj/sfz051. eCollection 2020 Feb.

Authors

Xavier Charmetant¹, Cécile Teuma^{1

2}, Jennifer Lake³, Frédérique Dijoud⁴, Vincent Frochot⁵, Abbas Deeb¹

Affiliations

¹ Department of Nephrology, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Pierre-Bénite, France.
² Immunology Cancer Research (ImmuCare), Institut de Cancérologie des Hospices Civils de Lyon, Lyon, France.
³ Institute of Physiology, University of Zurich, Zürich, Switzerland.
⁴ Department of Pathology, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron, France.
⁵ Department of Physiology, Hôpital Tenon, APHP, Paris Cedex 20, France.

Abstract

The main manifestation of acute interstitial nephritis (AIN) due to immune checkpoint inhibitors is acute kidney injury. We report here a biopsy-proven AIN revealed by tubular acidosis. This case highlights that immune checkpoint inhibitor prescribers must be aware of electrolytic disorders since tubular dysfunction can precede serum creatinine increase and reveal renal toxicity.

Keywords: distal tubular acidosis; immune checkpoint inhibitors; nephrotoxicity.

Publication types

Case Reports