While programmed death-1 (PD-1) antibodies play an important role in the treatment of advanced gastric cancer, these treatments can cause immune-related adverse events (irAEs). irAEs can affect multiple body systems, vary in severity, and have diverse clinical manifestations. Vitiligo-like depigmentation and acute kidney injury are relatively rare irAEs observed in clinical practice. This report describes the case of a patient with advanced gastric cancer who developed vitiligo-like depigmentation and acute kidney injury eight weeks after treatment with a PD-1 antibody combined with chemotherapy. The patient refused steroid treatment, leading to a progressive increase in serum creatinine concentration, recurrent proteinuria, sterile pyuria, and hematuria. Depigmentation was notably evident in sun-exposed areas of the face and both upper limbs. Eighteen weeks after discontinuing PD-1 treatment, the patient’s serum creatinine level and glomerular filtration rate had returned to normal levels, while the pyuria, hematuria, and proteinuria normalized. However, the vitiligo-like depigmentation showed no improvement. This case demonstrates that mild immunotherapy-induced acute kidney injury can show partial or complete renal function recovery without steroid treatment after cancer treatment discontinuation; however, without intervention, vitiligo-like depigmentation is difficult to improve.