Complications from Systemic Treatment in a Urothelial Bladder Cancer Patient with Chronic Kidney Disease: A Case Study
Overview
This case study details the complications experienced by a 72-year-old male patient with urothelial bladder cancer and chronic kidney disease during treatment with nivolumab.
Background
Urothelial bladder cancer is a prevalent malignancy, particularly affecting older adults. Patients with chronic kidney disease often face limitations in treatment options, as standard cisplatin-based chemotherapy is typically contraindicated. Immune checkpoint inhibitors, such as nivolumab, provide an alternative treatment option.
Data Highlights
No numerical data or trial data provided in the article.
Key Findings
The patient developed severe immune-related adverse events after three cycles of nivolumab.
Symptoms included diffuse myalgia, progressive weakness, and paresthesia, complicating the assessment of CKD progression.
Laboratory results indicated leukocytosis, elevated liver enzymes, and normal creatine kinase levels.
High-dose glucocorticosteroids improved symptoms, but recurrence during tapering necessitated re-escalation of therapy.
Multidisciplinary evaluation revealed chronic steroid toxicity and secondary testosterone deficiency.
Coordinated care from multiple specialties was essential for management and recovery.
Clinical Implications
Monitoring for immune-related adverse events in patients receiving ICIs is important, particularly those with CKD.
Conclusion
This case contributes insights into the management of patients with urothelial carcinoma and CKD undergoing immunotherapy.
