Renale Komplikationen bei Immuntherapien von Malignomen

ZUSAMMENFASSUNG

Durch ein targetspezifisches Vorgehen stellen Immuntherapien eine neue hocheffektive Therapieform bei fortgeschrittenen Malignomen dar, zunehmende Verbreitung findet in diesem Feld insbesondere die Therapie mit Immun-Checkpoint-Inhibitoren (CPI). Allerdings kann es hierunter neben anderen immunvermittelten unerwünschten Nebenwirkungen zu renalen Komplikationen kommen. Eine hierdurch bedingte Nephrotoxizität ist häufiger als initial angenommen und tritt teilweise erst mit einer deutlichen Latenz auf. Histologisch handelt es sich in den meisten Fällen um eine akute interstitielle Nephritis. Diese lässt sich i. d. R. durch Stoppen der CPI-Therapie und Gabe von Kortikosteroiden gut therapieren. Die renale Prognose ist unter Anwendung dieser Maßnahmen überwiegend gut. Andere Immuntherapien von Tumoren spielen hinsichtlich der Nephrotoxizität eine eher untergeordnete Rolle, wobei mit zunehmender Verbreitung einer CAR-T-Zell-Therapie zukünftig auch die renalen Nebenwirkungen berücksichtigt werden sollten.

Publication History

Article published online:
27 May 2021

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