1. PD-1抑制剂属于大分子蛋白药物,不通过肾排泄及肝酶代谢;2. 小样本研究提示基线肾功能不全的患者使用PD-1抑制剂后,irAE发生率未增加,器官功能也未进一步恶化。3. 多个病例报导提示正在接受透析治疗的肾细胞癌患者使用PD-1抑制剂后,irAE发生率未增加。参考文献 1. Kanz et al. Safety and efficacy of anti-PD-1 inpatients with baseline cardiac, renal, or hepatic dysfunction. Journal forImmunoTherapy of Cancer (2016) 4:602. Ansari J, Ali M, Farrag A, Ali AM, Alhamad A. Efficacyof Nivolumab in a Patient with Metastatic Renal Cell Carcinoma and EndStageRenal Disease on Dialysis: Case Report and Literature Review. Case ReportsImmunol. 2018 Jun;2018:1623957.3. Carlo MI, Feldman DR. Response to Nivolumab in aPatient With Metastatic Clear Cell Renal Cell Carcinoma and End-stage Renal Diseaseon Dialysis. Eur Urol. 2016 Dec;70(6): 1082–3.4. Tabei T, Natsume I, Kobayashi K. Successful treatmentof metastatic clear cell carcinoma with nivolumab in a patient receivingdialysis treatment. Int J Urol. 2017 Sep;24(9):708–10.5. Ryota Morinaga, et.al. Longer Control of Nivolumab inMetastatic Renal Cell Carcinoma Patients With End-Stage Kidney Disease onDialysis. Case Rep Oncol. 2019 Aug 6;12(2):608-612.6. Ignacio Osmán-García, et.al. Outcomes and Safety ofBiweekly and Monthly Nivolumab in Patients with Metastatic Renal Cell Carcinomaand Dialysis: Three Case Reports and Literature Review. Urol Int. 2020;104(3-4):323-326.