Table 3.
Management of patients with AKI from suspected/confirmed immune checkpoint–related acute interstitial nephritis
| Patient | Drug | ICI Withheld | PPI Withheld | Steroids Initiated | IV Pulse Steroids | Total IV Steroids (g) | Prednisone Starting Dose (mg) | Prednisone Starting Dose (mg/kg) | Approximate Weekly Steroid Taper Regimen (mg) | Renal Response | Nadir Creatinine (mg/dl) | Cancer Outcome | Patient Outcome | |
| No. 1 | Nivolumab | Yes | Yes | Yes | Yes | 0.75 | 60 | 1.0 | 60–60–40–20–10–5–X | PR | 1.6 | Progression | Hospice | |
| No. 2 | Nivolumab | Yes | Yes | Yes | No | — | 60 | 0.9 | 60–80–40–20–20–20–20–20–20–20–hospice | CR | 1.2 | Unknown | Deceased | |
| No. 3 | Nivolumab | Yes | Yes | Yes | No | — | 40 | 0.5 | 40–30–20–15–7.5–5-4–3-2–1–X | PR | 1.22 | Complete response | Alive | |
| No. 4 | Nivolumab and ipilimumab | Yes | NA | Yes | Yes | 1 | 60 | 0.7 | 60–60–60–60–40–40–40–40–20–10–5–4–3–2–1–X | CR | 1.3 | Progression | Deceased | |
| No. 5 | Nivolumab and ipilimumab | Yes | No | Yes | Yes | 9.75 | 100 | 1.1 | 100–80–60–40–30–20–10–7.5–5–2.5–X | CR | 1.1 | Complete response | Alive | |
| No. 6 | Nivolumab and ipilimumab | Yes | Yes | Yes | Yes | 3 | 80 | 0.79 | 80–60–40–30–20–10–20–40–30–20–10–5–X | PR | 1.5 | Complete Response | Alive | |
| No. 7 | Nivolumab and ipilimumab | Yes | NA | No | No | — | — | — | — | PR | 1 | Progression | Alive on therapy | |
| No. 8 | Pembrolizumab | Yes | Yes | Yes | Yes | 0.25 | 40 | 0.77 | 40–30–30–30–30–20–15–15–10–7.5–7.5–5–2.5–X | CR | 1 | Progression | Deceased | |
| No. 9 | Pembrolizumab | Yes | Yes | Yes | No | — | 60 | 0.78 | 60–50–40–30–40–40–35–30–25–20–15–10–5–X | CR | 1.5 | Complete response | Alive | |
| No. 10 | Pembrolizumab | Yes | Yes | Yes | No | — | 60 | 0.66 | 60–40–20–20–15–10–> | CR | 1.1 | Progression | Deceased | |
| No. 11 | Pembrolizumab | Yes | No | Yes | No | — | 30 | 0.38 | 30–20–10–5-65–60–50–40–30–20–10–7.5–5–2.5–X | PR | 1.5 | Progression | Deceased | |
| No. 12 | Pembrolizumab | Yes | No | No | No | — | — | — | — | NR | 6.4 | Progression | Deceased | |
| No. 13 | Pembrolizumab | Yes | Yes | Yes | Yes | 2 | 60 | 1.0 | 60–40–30–30–20–10–5–X | CR | 1.1 | Complete response | Alive | |
| No. 14 | Pembrolizumab | Yes | NA | Yes | Yes | 5 | 60 | 0.68 | 60–40–20–10–5–2.5–X | CR | 1.1 | Stable | Alive on therapy | |
ICI, immune checkpoint inhibitor; PPI, proton pump inhibitor; IV, intravenous; X, stopped; >, dose continued at the time of last follow up; PR, partial response (creatinine improved from peak but did not return to within 0.3 mg/dl of baseline); CR, complete response (creatinine improved to a value within 0.3 mg/dl of baseline creatinine); NA, not applicable; NR, no response (creatinine unchanged or worsened).