Avelumab
Bavencio · Anti-PD-L1 antibody
ICI-associated AIN.
Jemperli · DOST
Anti-PD-1 antibody · approved 2021 · 9 citations
Describes how this page is sourced, not how dangerous the drug is. Thinly sourced means fewer of the sourcing signals are met — not that the agent is kidney-safe. A rule-based summary, not a formal certainty appraisal.
An anti-PD-1 antibody that, like its class, can cause immune-mediated acute interstitial nephritis and rare glomerular disease.
Signature lesion
Consistent with the PD-1/PD-L1 class: any AKI in roughly 15-17% of treated patients, with immune-related AIN in a smaller clinically significant subset. As a newer anti-PD-1 agent, dostarlimab-specific renal incidence is not separately quantified. A separate real-world cohort of 1,037 ICI-treated patients supplies the drug-attributable denominator this class otherwise lacks: 18.2% developed AKI of any cause, but only 3.6% (37 patients) had AKI attributed to the checkpoint inhibitor itself — a class figure, not a dostarlimab-specific one.Source: Lumlertgul et al., Eur J Cancer 2023 (class-level ICI-attributed AKI 3.6%; agent-specific AIN rate not separately quantified)
Weeks to months after initiation.
Distilled from: “Weeks to months after initiation.”
In the multicenter ICI-AKI cohort ~22% were rechallenged and ~23% of those developed recurrent AKI — feasible but an individualized, co-managed decision. PMID 31896554 (opens PubMed in a new tab)
Class-level checkpoint-inhibitor AKI recovery: in a 138-patient multicenter ICI-AKI cohort, complete, partial, and no recovery of kidney function occurred in roughly 40%, 45%, and 15% of patients respectively. Two covariates carried a better renal prognosis — treatment with steroids, and the PRESENCE of a concomitant tubulointerstitial-nephritis-causing medication (69% of patients were on one). The second is an observational association, not an intervention: the cohort analysed no effect of stopping that drug, and the likeliest reading is that a competing culprit makes the ICI a less certain cause. Rechallenge is feasible in selected patients but recurrent AKI occurs in about a quarter.PMID 31896554 (opens PubMed in a new tab)
Long-term outcome and threshold data distilled from the agent's cited literature — educational, not a substitute for the primary sources.
Recovery across agentsThis agent's kidney lesions ordered by prominence — the #1 signature lesion first, then secondary and rare patterns. Cited incidence is shown where a citable figure exists; otherwise the tier stands qualitatively.
Anti-PD-1 renal toxicity ~1-5%, predominantly acute interstitial nephritis PMID 40616770 (opens PubMed in a new tab)
Much rarer than AIN; dostarlimab crescentic GN / pulmonary-renal syndrome case reported PMID 40616770 (opens PubMed in a new tab)
Tap a signature to trace where it strikes the nephron.
Acute Interstitial Nephritis
Immune-mediated inflammation of the renal interstitium — the signature kidney injury of checkpoint inhibitors.
Humanized IgG4 monoclonal antibody blocking the PD-1 receptor, restoring antitumor T-cell function. Used in mismatch-repair-deficient/MSI-high endometrial and other solid tumors, including chemoimmunotherapy combinations.
27 grade-indexed syndromes across 11 organ systems, written for checkpoint blockade as a class rather than per agent — where a rate differs between anti-PD-1, anti-PD-L1, anti-CTLA-4 and combination therapy, the card names the class it was measured in.
Class-level context for the major non-renal toxicities of the Anti-PD-1 antibody class.
Endocrine
Thyroiditis, hypophysitis, diabetes
Gastrointestinal
Diarrhea, colitis, mucositis, perforation
Hepatic / Liver
Transaminitis, hepatitis, VOD/SOS
Pulmonary
Pneumonitis, ILD, effusions, hypertension
Dermatologic
Rash, HFS, SJS/TEN, vitiligo
8 primary references — trials, cohorts, mechanism, and reviews. Single-patient case reports are listed separately below, graded by strength. Citation metadata via PubMed / NLM.
Primary (non–case-report) references per year — a proxy for how actively the agent's renal literature is accruing. Recent years are highlighted. Reflects curation depth, not a systematic bibliometric count.
Single-patient and small-series reports, graded by evidentiary strength — A Strong (biopsy-proven plus a series and/or positive rechallenge), B Moderate, and C Limited (a single clinically-diagnosed case). Strongest first. Grades are inferred automatically from each report's abstract and journal — a heuristic ranking aid, not a formal quality appraisal.
Everything below is FAERS — adverse events someone chose to report, about 2,264 of them for this agent. Nobody counts the patients who were fine, so none of these numbers is an incidence, a risk, or a rate: they describe what gets reported, shaped by a drug's fame, its indication, and who was watching. How these numbers work.
Only significant signals appear (95% CI lower bound above 1) — a phenotype missing here was tested and did not reach significance, except Prerenal / Hemodynamic AKI, Pseudo-AKI, Renal Cysts, Chronic Interstitial Nephropathy — outside the clinician-reviewed MedDRA term map, never queried — and ATN and AIN, queried but biopsy-bound: real cases are filed as generic “acute kidney injury”, so their absence is not a negative. As of 2026-10-01.
What reporting says about this profile's documented lesions
Reported with a death outcome
274 of 2,264 reports
Reported with hospitalization
878 of 2,264 reports
Reports per year
Yearly FAERS report volume · most recent year is partial.
Bars rank systems by summed reaction-term mentions (a report counts once per term it names) — an ordinal “more vs less reported” cue, not a tally of distinct reports. Renal & urinary first. As of 2026-10-01.
Each recommendation below is this atlas's faithful summary of the source, not a quotation from it — follow the PubMed link for the wording the society published. Summaries may be superseded; consult the current full text and individualize to the patient.
General onco-nephrology references
Where Dostarlimab sits in nephrotoxicity space — each dot is an anti-cancer agent, positioned so neighbors share a kidney-injury phenotype. Its 6 closest are filled and lead to a numbered marker, matching the numbered cards below.
Bavencio · Anti-PD-L1 antibody
ICI-associated AIN.
Libtayo · Anti-PD-1 antibody
ICI-associated AIN.
Imfinzi · Anti-PD-L1 antibody
ICI-associated AIN.
Loqtorzi · PD-1 immune checkpoint inhibitor
First FDA-approved drug for nasopharyngeal carcinoma; renal risk is class-typical immune-mediated interstitial nephritis.
Unloxcyt · PD-L1 immune checkpoint inhibitor
PD-L1 blockade for cutaneous SCC — watch for late immune interstitial nephritis
Tecentriq · Anti-PD-L1 antibody
Interstitial nephritis; rare glomerular disease.
Nearest agents by kidney-injury phenotype (shared injuries, nephron target, severity, class) — a similarity approximation, not a claim of shared drug identity or mechanism.
Same-class agents ordered by their documented kidney-injury profile — atlas severity, an acute-kidney-injury FAERS signal, and how many injury types each is documented to cause. Agents nearer the top carry the lighter documented renal profile.
A comparison of documented kidney-injury data within one drug class — not a substitution recommendation. Efficacy, indication, and non-renal toxicity differ between these agents and are out of scope here. Educational only, not medical advice.