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
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.
Topics & Concepts
MedicineHypokalemiaAcidosisAdverse effectInterstitial nephritisRenal tubular acidosisAcute kidney injuryDistal renal tubular acidosisInternal medicineImmune systemGastroenterologyKidneyImmunologyPotassium and Related DisordersCancer Immunotherapy and BiomarkersPneumocystis jirovecii pneumonia detection and treatment