Ipilimumab-induced nephritis is a rare but serious immune-related complication that occurs on average 7 weeks after initiation of treatment. The most common symptoms are fatigue (26.7%), fever (20%), rash (13.3%) and weight loss (13.3%). Laboratory findings include elevated serum creatinine (median 3.4 mg/dL), eosinophilia (18.5%), proteinuria (14.8%), and urinary tract infections (11.1%). Histologically, acute tubulointerstitial nephritis dominates (87.5%), less often IgA nephropathy or interstitial edema. Treatment consists of immediate discontinuation of ipilimumab and administration of systemic corticosteroids; in some cases, additional immunosuppressants or renal replacement are used. Clinical improvement occurs in 93.3% of patients with a median recovery of 7 weeks, while mortality is low (3.3%). Early recognition and rapid intervention are key to mitigating kidney damage.