Abstract: SA-PO0312
Biopsy-Proven Acute Interstitial Nephritis Associated with Immune Checkpoint Inhibitors: A Systematic Review of Clinicopathologic Features, Management, and Outcomes
Session Information
- AKI: Epidemiology and Risk Factors
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 101 AKI: Epidemiology, Risk Factors, and Prevention
Authors
- Prasad, Sai Raghavendra, B V V Sangha's S Nijalingappa Medical College and H S K Hospital and Research Centre, Bagalkot, KA, India
- Ahuja, Aarushi, Maulana Azad Medical College, New Delhi, DL, India
- Ratan, Piyush, Patna Medical College and Hospital, Patna, BR, India
- Rana, Richa N., GMERS Medical College and Hospital Sola, Ahmedabad, GJ, India
- Huilgol, Sandeep Gopinath, Dr. Huilgol's Kidney Care, Bagalkote, Karnataka, India
- Nagda, Jay Jayantilal, MP Shah Medical College, Jamnagar, GJ, India
- ., Archita, Ziauddin University, Karachi, Sindh, Pakistan
- Venkatesh, Karthik Kanna, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, PY, India
- Kunapareddy, Urvija Padmini, Employees' State Insurance Corporation, Hyderabad, Telangana, India
- Sundaravadivelu, Vasunthra, Stanley Medical College, Chennai, TN, India
- Agrawal, Shreya, Government Medical College Patiala, Indra Puri Colony, PB, India
- Agarwal, Jhanvi, Bharati Vidyapeeth (Deemed to be University), Pune, MH, India
- Priya, Shambhavi, Saheed Laxman Nayak Medical College and Hospital, Koraput, OD, India
Background
Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment; however, they are associated with immune-related adverse events, including acute interstitial nephritis (AIN). Although ICI-associated acute kidney injury is increasingly recognized, comprehensive data on biopsy-proven AIN are limited.
Methods
A systematic literature search was conducted in PubMed, Embase, and Scopus from database inception to January 2026. Eligible studies included case reports, case series, and retrospective studies that reported biopsy-proven AIN in adults receiving ICIs. Data extraction included patient demographics, ICI type, clinical presentation, histopathological findings, management, and renal outcome. Rayyan was used for screening, and the risk of bias was assessed using the Joanna Briggs Institute checklists for case reports and case series and the Newcastle-Ottawa Scale for cohort studies.
Results
Of the 774 records identified, 41 studies comprising 93 patients with biopsy-proven ICI-associated AIN were included in the analysis. The majority were case reports (67%) and case series (14%). Risk of bias assessment showed generally high-quality reporting across the domains. Nivolumab and pembrolizumab were the most commonly implicated ICIs, and lung adenocarcinoma and melanoma were the predominant underlying malignancies. Corticosteroids were the primary treatment. Complete or partial renal recovery was achieved in more than 75% of patients, while renal replacement therapy was required in approximately 19%. Relapse occurred in 17% of patients, and ICI rechallenge was attempted in 15% of patients, with variable outcomes.
Conclusion
ICI-associated AIN is an important immune-related adverse event with heterogeneous renal outcomes. Early recognition, kidney biopsy confirmation, and timely corticosteroid therapy are associated with improved renal recovery outcomes. Further prospective studies and standardized reporting are required to optimize management strategies.