Safety and efficacy of immune checkpoint inhibitors for end-stage renal disease patients undergoing dialysis: a retrospective case series and literature review

  • Hyeon Cheun
  • Miso Kim
  • Hajeong Lee
  • Kook-Hwan Oh
  • Bhumsuk KeamEmail author


Despite the lack of safety and efficacy data regarding immune checkpoint inhibitors (ICIs) for renal dysfunction, they have been approved to treat even in the patients with end-stage renal disease (ESRD). We report our experience with ICI administration to three ESRD patients undergoing hemodialysis. One of the patients had a partial response for several months; however, the other patients had a stable disease while undergoing dialysis. The toxicity was tolerable; however, one patient developed grade 2 pneumonitis. A literature review of other rarely reported cases of hemodialysis revealed that 10 out of 13 patients had a partial response or complete response; in addition, grade 3 or grade 4 immune-related adverse events occurred in 3 patients. ESRD combined with dialysis may not be a contraindication for the use of ICIs. ICIs can be beneficial to ESRD patients undergoing dialysis. However, caution is needed regarding immune-related adverse events. Further prospective studies involving pharmacokinetic analyses are necessary to obtain reliable safety and efficacy data.


Immune checkpoint inhibitor End-stage renal disease Dialysis 



This research did not receive any specific grant from any funding agencies in the public, commercial, or not-for-profit sectors.

Compliance with ethical standards

Conflict of interest

The authors declared that they have no conflict of interest.

Research involving human participants

This work was performed in humans with approval from the Institutional Review Board.

Informed consent

The Institutional Review Board granted a waiver for this retrospective study.


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© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Seoul National University College of MedicineSeoulSouth Korea
  2. 2.Department of Internal MedicineSeoul National University HospitalSeoulSouth Korea
  3. 3.Cancer Research InstituteSeoul National UniversitySeoulSouth Korea

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