Immune checkpoint inhibitor-associated nephritis-treatment standard

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Conflicts of Interest

Identified Weaknesses

Rating Explanation

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Paper Summary

Paperzilla title

Kidney Complications from Cancer Immunotherapy: What We Know So Far

This review summarizes current knowledge and treatment approaches for immune checkpoint inhibitor (ICI)-associated acute kidney injury (AKI), a side effect of cancer immunotherapy. It focuses on acute tubulointerstitial nephritis (ATIN), the most common form of ICI-AKI, discussing diagnosis, treatment, and outcomes, emphasizing the need for more prospective studies.

Possible Conflicts of Interest

One author (SMH) has received research funding from intramural and Mayo Clinic grants. No specific funding was disclosed for the preparation of this manuscript.

Identified Weaknesses

Reliance on Retrospective Studies

The review heavily depends on retrospective studies, which are prone to biases and may not accurately reflect the true incidence and outcomes of ICI-AKI. Prospective studies are needed for higher-quality evidence.

Lack of Standardized Definitions

Different definitions of renal recovery make it difficult to compare results across studies and hinder clear conclusions about the effectiveness of treatments.

Limited Biopsy Data

Kidney biopsy is the gold standard for diagnosing ICI-AKI, but many included studies lack biopsy confirmation, potentially misclassifying cases and affecting treatment decisions.

Rating Explanation

This is a comprehensive review of an important topic in onco-nephrology. It summarizes the current understanding of ICI-AKI and highlights key areas for future research. While it relies on retrospective studies, this is a limitation of the current evidence base. The authors acknowledge this weakness and call for more prospective research. Potential COI noted but seems minimal.

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