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3. Vacuolar tubular injury after exposure to immune check-point inhibitor

Author

Vishnu P Parvathareddy, William Glass, and Biruh T Workeneh

Abstract

Renal toxicities have been increasingly recognized as complications of immune checkpoint inhibitor therapy. These drugs are associated with a broad range of immune-related adverse events in the kidney, including interstitial nephritis, glomerulonephritis, and acute tubular necrosis. We describe a woman with a rare pattern of injury, osmotic tubulopathy, after exposure to pembrolizumab that has been described only once before in the medical literature. As a result of these observations, vacuolar tubular injury pattern that has the appearance of an osmotic lesion should be considered as a possible consequence of immune checkpoint inhibitor therapy.

Published
2022
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5. List of contributors

Author

Marcin Adamczak, Maria Ida Amabile, Ibironke W. Apata, Mugurel Apetrii, Carla Maria Avesani, Udo Bahner, James L. Bailey, Anip Bansal, Christophe Barba, Ezequiel Bellorin-Font, Rachelle Bross, Amanda Brown-Tortorici, Michel Burnier, Jerrilynn Denise Burrowes, Juan Jesús Carrero, MacKenzie K. Cervantes, Steven Chadban, Vimal Chadha, Maria Chan, Winnie Chan, Charles Chazot, Janet M. Chiang, Michel Chonchol, Lydia Chwastiak, Adrian Covic, Lilian Cuppari, Neera K. Dahl, Biagio Di Iorio, Francesca Di Mario, Wilfred Druml, Ramanath Dukkipati, Gholamreza Fazeli, Enrico Fiaccadori, Fredric Finkelstein, Denis Fouque, Harold A. Franch, Allon N. Friedman, Pranav S. Garimella, Richard J. Glassock, David S. Goldfarb, Ailema González-Ortiz, Nimrit Goraya, Orlando M. Gutiérrez, Norio Hanafusa, August Heidland, Olof Heimbürger, Raimund Hirschberg, T. Alp Ikizler, Kirsten Johansen, Richard J. Johnson, Shivam Joshi, Kamyar Kalantar-Zadeh, Duk-Hee Kang, George A. Kaysen, Jun-Chul Kim, Brandon Kistler, Laetitia Koppe, Joel D. Kopple, Csaba P. Kovesdy, Holly J. Kramer, Kiyoshi Kurokawa, Bengt Lindholm, Kevin J. Martin, Steve Martino, Stefania Marzocco, Shaul G. Massry, Ziad A. Massy, William E. Mitch, Toshio Miyata, Alessio Molfino, Hamid Moradi, Takahiko Nakagawa, Yoko Narasaki, Nancy Puzziferri, Noel Quinn, Dominic S. Raj, Kalani L. Raphael, Renu Regunathan-Shenk, Connie M. Rhee, Eberhard Ritz, Alice Sabatino, Mark J. Sarnak, Julia Scialla, Lothar Seefried, John Sellinger, Anuja Shah, Neal B. Shah, Sudhir V. Shah, Manisha Singh, Leonardo Spatola, Robert C. Stanton, Alison L. Steiber, Peter Stenvinkel, David E. St-Jules, Thomas W. Storer, Keiichi Sumida, Elizabeth J. Sussman-Dabach, Sundararaman Swaminathan, John Sy, Ekamol Tantisattamo, Nosratola D. Vaziri, Alexandra Voinescu, Angela Yee-Moon Wang, Bradley A. Warady, Daniel E. Weiner, Donald E. Wesson, Andrzej Wiecek, Mark E. Williams, Bruce M. Wolfe, Biruh T. Workeneh, and Ying-Yong Zhao

Published
2022
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8. Sodium and Potassium Dysregulation in the Patient With Cancer

Author

Praveen Ratanasrimetha, Biruh T. Workeneh, and Harish Seethapathy

Subjects
Hypernatremia, Nephrology, Neoplasms, Sodium, Potassium, Humans, Hyperkalemia, Hypokalemia, Hyponatremia
Abstract

Sodium and potassium disorders are pervasive in patients with cancer. The causes of these abnormalities are wide-ranging, are often primary or second-order consequences of the underlying cancer, and have prognostic implications. The approach to hyponatremia should focus on cancer-related etiologies, such as syndrome of inappropriate antidiuretic hormone, to the exclusion of other causes. Hypernatremia in non-iatrogenic forms is generally due to water loss rather than excessive sodium intake. Debilitated or dependent patients with cancer are particularly vulnerable to hypernatremia. Hypokalemia can occur in patients with cancer due to gastrointestinal disturbances, resulting from decreased intake or increased losses. Renal losses can occur as a result of excessive mineralocorticoid secretion or therapy-related nephrotoxicity. The approach to hyperkalemia should be informed by historical and laboratory clues, and pseudohyperkalemia is particularly common in patients with hematological cancers. Hyperkalemia can be seen in primary or metastatic disease that interrupts the adrenal axis. It can also develop as a consequence of immunotherapy, which can cause adrenalitis or hypophysitis. Tumor lysis syndrome (TLS) is defined by the development of hyperkalemia and is a medical emergency. Awareness of the electrolyte abnormalities that can befall patients with cancer is vital for its prompt recognition and management.

Published
2022
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9. List of Contributors

Author

Mauro Abbate, Horacio J. Adrogué, Seth L. Alper, Robert J. Alpern, Radhakrishna Baliga, Daniel Batlle, José F. Bernardo, Theresa J. Berndt, Mark O. Bevensee, Jürg Biber, René J.M. Bindels, Henrik Birn, Walter F. Boron, D. Craig Brater, Edward M. Brown, Gerhard Burckhardt, Simone M.R. Camargo, Michael J. Caplan, Andrés Cárdenas, Sheldon Chen, Erik Ilsø Christensen, Moonja Chung-Park, Fredric L. Coe, Kirk P. Conrad, Christopher J. Cooper, Norman P. Curthoys, Prasad Devarajan, Matthew Diamond, Cristina Dumitru, Lance D. Dworkin, Kai-Uwe Eckardt, Zoltán Huba Endre, Andrew Evan, Ronald J. Falk, Ian C. Forster, Peter A. Friedman, Clarice Kazue Fujihara, John P. Geibel, Kathleen M. Giacomini, Pere Ginès, Simin Goral, Mitchell Halperin, L. Lee Hamm, Syed K. Haque, Steven C. Hebert, J. Harold Helderman, William L. Henrich, Nati Hernando, Joost G.J. Hoenderop, Jonathon W. Homeister, Charles S. Hummel, J. Charles Jennette, Kamel S. Kamel, S. Ananth Karumanchi, Clifford E. Kashtan, Charbel Khoury, Robert Kleta, Hermann Koepsell, Martin Konrad, Reto Krapf, Rajiv Kumar, Armin Kurtz, Ira Kurtz, Anthony J. Langone, Shih-Hua Lin, Marshall D. Lindheimer, Christopher Y. Lu, Daniela Macconi, Michael Madaio, Nicolaos E. Madias, Victoria Makrides, Anup Manoharon, Pär Matsson, William E. Mitch, Orson W. Moe, Bruce A. Molitoris, Heini Murer, Eugene Nattie, Rikke Nielsen, Biff F. Palmer, Patricia A. Preisig, Gary A. Quamme, L. Darryl Quarles, Mohan Rajapurkar, Giuseppe Remuzzi, Daniela Riccardi, Heidi Schaefer, Jeffrey R. Schelling, Karl P. Schlingmann, Robert W. Schrier, John R. Sedor, Yoav Segal, Donald W. Seldin, Sudhir V. Shah, Asif Sharfuddin, Stefan Somlo, Andrew K. Stewart, Peter J. Tebben, Vicente E. Torres, François Verrey, Robert James Walker, Roland H. Wenger, Elaine Worcester, Biruh T. Workeneh, Ernest M. Wright, John Wysolmerski, Sung-Sen Yang, Roberto Zatz, Fuad N. Ziyadeh, and Carla Zoja

Published
2012
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