Immune checkpoint inhibitor-related acute kidney injury: A diagnostic and therapeutic challenge for nephrologists

doi:10.5527/wjn.v15.i1.114239

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World Journal of Nephrology

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2220-6124

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Nephrol. Mar 25, 2026; 15(1): 114239
Published online Mar 25, 2026. doi: 10.5527/wjn.v15.i1.114239

Table 4 Biomarkers for immune checkpoint inhibitor-related acute kidney injury

Biomarker	Sample type	Evidence/findings
C-reactive protein	Biochemistry	Elevated in ICI-AKI vs non-ICI-AKI[22]
Urine retinol binding protein to urine creatinine ratio	Urine	Elevated in ICI-AKI vs non-ICI-AKI[22]
Soluble interleukin-2 receptor	Biochemistry	1.75 × ULN cut-off: 81% sensitivity, 100% specificity for ICI-AITN (n = 24) vs ICI-treated (n = 10) and haemodynamic AKI (n = 6) controls[23]
CD8+ T lymphocytes	Flow cytometry	Lower counts in ICI-related ATIN[23]
CD45RA+CD8+ T lymphocytes	Flow cytometry	Lower counts in ICI-related ATIN[23]
Memory CD27+ B lymphocytes	Flow cytometry	Lower counts in ICI-related ATIN[23]
Plasmablasts	Flow cytometry	Expansion associated with ICI-related ATIN[23]
TNF-α	Urine	Strong predictor of ATIN[24] Elevated in ICI-AKI vs non-ICI-AKI[25]
IL-9	Urine	Elevated in ICI-AKI vs other AKI[24]
IL-2, IL-10	Urine	Elevated in ICI-AKI vs non-ICI-AKI[25]

All biomarkers are nonspecific and not diagnostic; validation in larger studies is required before routine clinical use. ICI: Immune checkpoint inhibitor; AKI: Acute kidney injury; ULN: Upper limit of normal; ATIN: Acute tubulointerstitial nephritis; TNF-α: Tumour necrosis factor alpha; IL: Interleukin.

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Citation: Javaid MM, Tonkin-Hill G, Klein M. Immune checkpoint inhibitor-related acute kidney injury: A diagnostic and therapeutic challenge for nephrologists. World J Nephrol 2026; 15(1): 114239
URL: https://www.wjgnet.com/2220-6124/full/v15/i1/114239.htm
DOI: https://dx.doi.org/10.5527/wjn.v15.i1.114239

Javaid MM, Tonkin-Hill G, Klein M. Immune checkpoint inhibitor-related acute kidney injury: A diagnostic and therapeutic challenge for nephrologists. World J Nephrol 2026; 15(1): 114239 [PMID: 41884237 DOI: 10.5527/wjn.v15.i1.114239]

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