Rapidly Progressive Acute Kidney Injury Associated with Nivolumab Treatment

Sachi Okawa; Keiichi Fujiwara; Atsushi Shimonishi; Hiroaki Matsuura; Taichi Ozeki; Jun Nishimura; Hiroe Kayatani; Daisuke Minami; Yoko Shinno; Ken Sato; Kosuke Ota; Takuo Shibayama

doi:10.1159/000505235

Rapidly Progressive Acute Kidney Injury Associated with Nivolumab Treatment

Case Rep Oncol. 2020 Feb 6;13(1):85-90. doi: 10.1159/000505235. eCollection 2020 Jan-Apr.

Authors

Affiliations

¹ Department of Respiratory Medicine, National Hospital Organization Okayama Medical Center, Okayama, Japan.
² Department of Pathology, National Hospital Organization Okayama Medical Center, Okayama, Japan.
³ Department of Nephrology, National Hospital Organization Okayama Medical Center, Okayama, Japan.

Abstract

A 63-year-old man with pulmonary adenocarcinoma was treated with nivolumab. High fever developed within several hours after the first administration of nivolumab; subsequently, serum creatinine levels kept increasing daily. We diagnosed acute kidney injury (AKI) as an immune-related adverse event; the patient was initially treated with 50 mg prednisolone, and the dose was then tapered. Renal biopsy pathologically revealed tubulointerstitial inflammation with strong infiltration of only T cells that were CD3⁺, CD4⁺, and CD8⁺. The infiltration of CD163⁺ M2 macrophage was also observed. AKI within 1 week after the administration of nivolumab seems to be rare; therefore, the present case provides important findings useful in daily clinical practice.

Keywords: Acute kidney injury; Acute tubular necrosis; Immune checkpoint inhibitors; Nivolumab; Renal biopsy.

Publication types

Case Reports