Renal toxicity due to ICI therapy is relatively uncommon, occurring in up to 5% of patients, with increased risk in patients receiving combination therapy. The most common renal toxicity observed is acute injury to the renal tubules and tubular space resulting in deleterious effects on kidney filtration. Clinical assessment includes diagnostic imaging, serum testing, possible biopsy analysis and consultation with a nephrologist to reduce the risk for irreversible damage to the renal system and to rule out other potential causes of kidney injury. Renal toxicity is often resolved with corticosteroid treatment and holding and/or discontinuation of immunotherapy is based on the severity of symptoms.
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