Acute Interstitial Nephritis
ICD-10 N12 · ICD-11 GB50

Treatment of Acute Interstitial Nephritis Associated with Immune Checkpoint Inhibitor (ICPI) Therapy

Clinical Scenario

This protocol addresses acute tubulointerstitial nephritis (ATIN) that develops as a complication of immune checkpoint inhibitor therapy. ATIN associated with ICPIs typically develops approximately 14 weeks after initiation of treatment, though onset can range considerably — from around 6 to 37 weeks after starting therapy.

Treatment Approach (Partial Overview)

Management centres on corticosteroid therapy as the cornerstone intervention. In the context of ICPI-associated ATIN, treatment duration considerations differ from standard ATIN management.

Full regimen details, dosing strategy, and duration guidance are available in the structured protocol.

Treatment Goals

The primary aim is improvement in kidney function, with the target of complete or partial renal recovery. Most patients show measurable clinical improvement following therapy, though mild kidney impairment may persist beyond the acute phase.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1016/j.ekir.2025.03.050

ATIN associated with ICPIs typically develops approximately 14 weeks (range: 6–37 weeks) after the initiation of treatment.

Corticosteroids remain the cornerstone of ATIN treatment, typically initiated with oral prednisolone or prednisone. An exception exists for ICPI-associated ATIN, where treatment may extend to 3 to 6 months.

Following therapy, most patients (64%) show clinical improvement with either complete or partial renal recovery, although mild kidney impairment persists at 12 months.

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