Clara García-Carro1, Mónica Bolufer1, Roxana Bury1, Zaira Castañeda1, Eva Muñoz2, Enriqueta Felip2, David Lorente3, María Josep Carreras4, Alejandra Gabaldon5, Irene Agraz1, Daniel Serón1, María José Soler1. 1. Nephrology Department, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Research, Barcelona, Spain. 2. Oncology Department, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona, Spain. 3. Urology Department, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Research, Barcelona, Spain. 4. Pharmacy Department, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Research, Barcelona, Spain. 5. Pathology Department, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Research, Barcelona, Spain.
Abstract
BACKGROUND: Checkpoint inhibitors (CPIs) have drastically improved metastatic cancer outcomes. However, immunotherapy is associated with multiple toxicities, including acute kidney injury (AKI). Data about CPI-related AKI are limited. Our aim was to determine risk factors for CPI-related AKI as well as its clinical characteristics and its impact on mortality in patients undergoing immunotherapy. METHODS: All patients under CPI at our centre between March 2018 and May 2019 and with a follow-up through April 2020 were included. Demographic, clinical and laboratory data were collected. AKI was defined according to the Kidney Disease: Improving Global Outcomes guidelines. We performed a logistic regression model to identify independent risk factors for AKI and actuarial survival analysis to establish risk factors for mortality in this population. RESULTS: A total of 759 patients were included, with a median age of 64 years. A total of 59% were men and baseline median creatinine was 0.80 mg/dL. The most frequent malignancy was lung cancer and 56% were receiving anti-programmed death protein 1 (PD-1). About 15.5% developed AKI during the follow-up. Age and baseline kidney function were identified as independent risk factors for CPI-related AKI. At the end of follow-up, 52.3% of patients had died. The type of cancer (not melanoma, lung or urogenital malignance), type of CPI (not cytotoxic T-lymphocyte-associated protein 4, PD-1, programmed death-ligand 1 or their combination) and the presence of an episode of AKI were identified as risk factors for mortality. CONCLUSIONS: A total of 15.5% of patients under immunotherapy presented with AKI. A single AKI episode was identified as an independent risk factor for mortality in these patients and age and baseline renal function were risk factors for the development of AKI.
BACKGROUND: Checkpoint inhibitors (CPIs) have drastically improved metastatic cancer outcomes. However, immunotherapy is associated with multiple toxicities, including acute kidney injury (AKI). Data about CPI-related AKI are limited. Our aim was to determine risk factors for CPI-related AKI as well as its clinical characteristics and its impact on mortality in patients undergoing immunotherapy. METHODS: All patients under CPI at our centre between March 2018 and May 2019 and with a follow-up through April 2020 were included. Demographic, clinical and laboratory data were collected. AKI was defined according to the Kidney Disease: Improving Global Outcomes guidelines. We performed a logistic regression model to identify independent risk factors for AKI and actuarial survival analysis to establish risk factors for mortality in this population. RESULTS: A total of 759 patients were included, with a median age of 64 years. A total of 59% were men and baseline median creatinine was 0.80 mg/dL. The most frequent malignancy was lung cancer and 56% were receiving anti-programmed death protein 1 (PD-1). About 15.5% developed AKI during the follow-up. Age and baseline kidney function were identified as independent risk factors for CPI-related AKI. At the end of follow-up, 52.3% of patients had died. The type of cancer (not melanoma, lung or urogenital malignance), type of CPI (not cytotoxic T-lymphocyte-associated protein 4, PD-1, programmed death-ligand 1 or their combination) and the presence of an episode of AKI were identified as risk factors for mortality. CONCLUSIONS: A total of 15.5% of patients under immunotherapy presented with AKI. A single AKI episode was identified as an independent risk factor for mortality in these patients and age and baseline renal function were risk factors for the development of AKI.
Authors: Ben Sprangers; David E Leaf; Camillo Porta; Maria José Soler; Mark A Perazella Journal: Nat Rev Nephrol Date: 2022-09-27 Impact factor: 42.439
Authors: Mónica Bolufer; Clara García-Carro; Miquel Blasco; Luis F Quintana; Amir Shabaka; Cristina Rabasco; Juliana Draibe; Ana Merino; María Rosa Melero; Fabiola Alonso; Anna Buxeda; Paula Batalha; Maria Teresa Visús; Maria José Soler Journal: J Clin Med Date: 2022-05-21 Impact factor: 4.964
Authors: Shruti Gupta; Samuel A P Short; Meghan E Sise; Jason M Prosek; Sethu M Madhavan; Maria Jose Soler; Marlies Ostermann; Sandra M Herrmann; Ala Abudayyeh; Shuchi Anand; Ilya Glezerman; Shveta S Motwani; Naoka Murakami; Rimda Wanchoo; David I Ortiz-Melo; Arash Rashidi; Ben Sprangers; Vikram Aggarwal; A Bilal Malik; Sebastian Loew; Christopher A Carlos; Wei-Ting Chang; Pazit Beckerman; Zain Mithani; Chintan V Shah; Amanda D Renaghan; Sophie De Seigneux; Luca Campedel; Abhijat Kitchlu; Daniel Sanghoon Shin; Sunil Rangarajan; Priya Deshpande; Gaia Coppock; Mark Eijgelsheim; Harish Seethapathy; Meghan D Lee; Ian A Strohbehn; Dwight H Owen; Marium Husain; Clara Garcia-Carro; Sheila Bermejo; Nuttha Lumlertgul; Nina Seylanova; Lucy Flanders; Busra Isik; Omar Mamlouk; Jamie S Lin; Pablo Garcia; Aydin Kaghazchi; Yuriy Khanin; Sheru K Kansal; Els Wauters; Sunandana Chandra; Kai M Schmidt-Ott; Raymond K Hsu; Maria C Tio; Suraj Sarvode Mothi; Harkarandeep Singh; Deborah Schrag; Kenar D Jhaveri; Kerry L Reynolds; Frank B Cortazar; David E Leaf Journal: J Immunother Cancer Date: 2021-10 Impact factor: 13.751
Authors: Megan L Baker; Yu Yamamoto; Mark A Perazella; Nazli Dizman; Anushree C Shirali; Navid Hafez; Jason Weinstein; Michael Simonov; Jeffrey M Testani; Harriet M Kluger; Lloyd G Cantley; Chirag R Parikh; F Perry Wilson; Dennis G Moledina Journal: J Immunother Cancer Date: 2022-03 Impact factor: 12.469