Citations 1
Acute kidney injury in patients treated with immune checkpoint inhibitors
Short, Samuel , Sise, Meghan E. , Prosek, Jason, Madhavan, Sethu M. , Soler, María José , Ostermann, Marlies , Abudayyeh, Ala , Anand, Shuchi , Motwani, Shveta S. , Murakami, Naoka , Wanchoo, Rimda, Ortiz-Melo, David I. , Rashidi, Arash , Aggarwal, Vikram , Malik, Abhinav , Loew, Sebastian, Carlos, Christopher A., Chang, Wei‐Ting , Beckerman, Pazit , Mithani, Zain, Renaghan, Amanda DeMauro , Seigneux, Sophie de , Campedel, Luca , Shin, Daniel Sanghoon , Rangarajan, Sunil , Deshpande, Priya , Coppock, Gaia, Eijgelsheim, Mark, Lee, Meghan , Husain, Marium , García-Carro, Clara , Bermejo, Sheila , Lumlertgul, Nuttha , Seylanova, Nina , Flanders, Lucy , Isik, Busra , Mamlouk, Omar , García, Pablo , Kaghazchi, Aydin , Khanin, Yuriy, Kansal, Sheru, Wauters, Els , Chandra, Sunandana , Hsu, Raymond K. , Tio, Maria Clarissa , Mothi, Suraj Sarvode, Singh, Harkarandeep , Reynolds, Kerry L. , Cortazar, Frank B. , Leaf, David E. , Salem, Joe‐Elie , Gupta, Shruti , Kitchlu, Abhijat , Lee, Meghan D , Mamlouk, Omar , Lin, Jamie S , Leaf, David E , Murakami, Naoka , Soler, Maria Jose , Salem, Joe-Elie , Hsu, Raymond K , Ostermann, Marlies , Koessler, Thibaud , Gupta, Shruti , Herrmann, Sandra M. , Glezerman, Ilya G , Sprangers, Ben , Malik, A Bilal, Shah, Chintan V , Kitchlu, Abhijat , Seethapathy, Harish Shanthanu , Strohbehn, Ian A. , Owen, Dwight H , Schmidt-Ott, Kai Martin , Schrag, Deborah , Jhaveri, Kenar D.
Journal for ImmunoTherapy of Cancer | October 10, 2021 | Volume: 9 | Issue: 10 | Pages: e003467
Background Immune checkpoint inhibitor-associated acute kidney injury (ICPi-AKI) has emerged as an important toxicity among patients with cancer. Methods We collected data on 429 patients with ICPi-AKI and 429 control patients who received ICPis contemporaneously but who did not develop ICPi-AKI from 30 sites in 10 countries. Multivariable logistic regression was used to identify predictors of ICPi-AKI and its recovery. A multivariable Cox model was used to estimate the effect of ICPi rechallenge versus no rechallenge on survival following ICPi-AKI. Results ICPi-AKI occurred at a median of 16 weeks (IQR 8–32) following ICPi initiation. Lower baseline estimated glomerular filtration rate, proton pump inhibitor (PPI) use, and extrarenal immune-related adverse events (irAEs) were each associated with a higher risk of ICPi-AKI. Acute tubulointerstitial nephritis was the most common lesion on kidney biopsy (125/151 biopsied patients [82.7%]). Renal recovery occurred in 276 patients (64.3%) at a median of 7 weeks (IQR 3–10) following ICPi-AKI. Treatment with corticosteroids within 14 days following ICPi-AKI diagnosis was associated with higher odds of renal recovery (adjusted OR 2.64; 95% CI 1.58 to 4.41). Among patients treated with corticosteroids, early initiation of corticosteroids (within 3 days of ICPi-AKI) was associated with a higher odds of renal recovery compared with later initiation (more than 3 days following ICPi-AKI) (adjusted OR 2.09; 95% CI 1.16 to 3.79). Of 121 patients rechallenged, 20 (16.5%) developed recurrent ICPi-AKI. There was no difference in survival among patients rechallenged versus those not rechallenged following ICPi-AKI. Conclusions Patients who developed ICPi-AKI were more likely to have impaired renal function at baseline, use a PPI, and have extrarenal irAEs. Two-thirds of patients had renal recovery following ICPi-AKI. Treatment with corticosteroids was associated with improved renal recovery.