Journal for ImmunoTherapy of Cancer (Oct 2021)
Acute kidney injury in patients treated with immune checkpoint inhibitors
- ,
- Joe-Elie Salem,
- Enriqueta Felip,
- Sophie Papa,
- Shuchi Anand,
- Karolina Benesova,
- Marlies Ostermann,
- Ala Abudayyeh,
- Omar Mamlouk,
- Umut Selamet,
- Grace Cherry,
- Sunandana Chandra,
- Sandra M Herrmann,
- Maria Jose Soler,
- Abhijat Kitchlu,
- Jamie S Lin,
- Kerry L Reynolds,
- Osama E Rahma,
- Elizabeth M Gaughan,
- Eva Muñoz-Couselo,
- Jamie S Hirsch,
- Pablo Garcia,
- Meghan D Lee,
- Harish Seethapathy,
- Ian A Strohbehn,
- Meghan E Sise,
- Wei-Ting Chang,
- Els Wauters,
- Lucy Flanders,
- Deborah Schrag,
- Thibaud Koessler,
- Mark Eijgelsheim,
- Shruti Gupta,
- Frank B Cortazar,
- Samuel A P Short,
- Jason M Prosek,
- Sethu M Madhavan,
- 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,
- Pazit Beckerman,
- Zain Mithani,
- Chintan V Shah,
- Amanda D Renaghan,
- Sophie De Seigneux,
- Luca Campedel,
- Daniel Sanghoon Shin,
- Sunil Rangarajan,
- Priya Deshpande,
- Gaia Coppock,
- Dwight H. Owen,
- Marium Husain,
- Clara Garcia-Carro,
- Sheila Bermejo,
- Nuttha Lumlertgul,
- Nina Seylanova,
- Busra Isik,
- Aydin Kaghazchi,
- Yuriy Khanin,
- Sheru K Kansal,
- Kai M Schmidt-Ott,
- Raymond K Hsu,
- Maria C Tio,
- Suraj Sarvode Mothi,
- Harkarandeep Singh,
- Kenar D Jhaveri,
- David E Leaf,
- Corinne Isnard Bagnis,
- Suraj S Mothi,
- Weiting Chang,
- Vipulbhai Sakhiya,
- Daniel Stalbow,
- Sylvia Wu,
- Armando Cennamo,
- Anne Rigg,
- Nisha Shaunak,
- Zoe A Kibbelaar,
- Harish S Seethapathy,
- Meghan Lee,
- Ian A Strohbhen,
- Ilya G Glezerman,
- Dwight H Owen,
- Sharon Mini,
- Andrey Kisel,
- Nicole Albert,
- Katherine Carter,
- Vicki Donley,
- Tricia Young,
- Heather Cigoi,
- Els Wauters Ben Sprangers,
- Javier A Pagan,
- Jonathan J Hogan,
- Valda Page,
- Samuel AP Short,
- A Bilal Malik,
- Maria Josep Carreras
Affiliations
- Joe-Elie Salem
- 21 Department of Pharmacology and CIC-1421, Assistance Publique-Hôpitaux de Paris, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
- Enriqueta Felip
- Oncology Department, Vall d’Hebron University Hospital, Vall d`Hebron Institute of Oncology, Barcelona, Spain
- Sophie Papa
- Shuchi Anand
- Division of Nephrology, Stanford University School of Medicine, Palo Alto, California, USA
- Karolina Benesova
- 1 Department of Internal Medicine V Hematology Oncology Rheumatology, Heidelberg University Hospital, Heidelberg, Germany
- Marlies Ostermann
- Department of Critical Care, King`s College London, Guy`s and St Thomas` Hospitals NHS Trust, London, London, UK
- Ala Abudayyeh
- Divison of Internal Medicine, Section of Nephrology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
- Omar Mamlouk
- Divison of Internal Medicine, Section of Nephrology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
- Umut Selamet
- Grace Cherry
- Sunandana Chandra
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, Illinois, USA
- Sandra M Herrmann
- Division of Nephrology & Hypertension, Mayo Clinic, Rochester, Minnesota, USA
- Maria Jose Soler
- Nephrology Department, Vall d’Hebron University Hospital, Vall d`Hebron Institute of Research, Barcelona, Spain
- Abhijat Kitchlu
- Division of Nephrology, University Health Network, University of Toronto, Toronto, Ontario, Canada
- Jamie S Lin
- Divison of Internal Medicine, Section of Nephrology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
- Kerry L Reynolds
- Division of Oncology, Massachusetts General Hospital, Boston, MA, USA
- Osama E Rahma
- Dana Farber Cancer Institute, Boston, Massachusetts, USA
- Elizabeth M Gaughan
- Eva Muñoz-Couselo
- Oncology Department, Vall d’Hebron Hospital Universitari, Barcelona, Catalunya, Spain
- Jamie S Hirsch
- Pablo Garcia
- Division of Nephrology, Stanford University School of Medicine, Palo Alto, California, USA
- Meghan D Lee
- Division of Nephrology, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harish Seethapathy
- Division of Nephrology, Massachusetts General Hospital, Boston, Massachusetts, USA
- Ian A Strohbehn
- Division of Nephrology, Massachusetts General Hospital, Boston, Massachusetts, USA
- Meghan E Sise
- Division of Nephrology, Massachusetts General Hospital, Boston, Massachusetts, USA
- Wei-Ting Chang
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Els Wauters
- Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
- Lucy Flanders
- Department of Oncology, Guy’s & St Thomas Hospital, London, UK
- Deborah Schrag
- Division of Population Sciences, Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Thibaud Koessler
- Mark Eijgelsheim
- Department of Internal Medicine, Division of Nephrology, University Medical Center Groningen, University of Groningen, Gronigen, The Netherlands
- Shruti Gupta
- Division of Renal Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA
- Frank B Cortazar
- New York Nephrology Vasculitis and Glomerular Center, Albany, New York, USA
- Samuel A P Short
- University of Vermont Larner College of Medicine, Burlington, Vermont, USA
- Jason M Prosek
- Division of Nephrology, Department of Internal Medicine, The Ohio State University Medical Center, Columbus, Ohio, USA
- Sethu M Madhavan
- Division of Nephrology, Department of Internal Medicine, The Ohio State University Medical Center, Columbus, Ohio, USA
- Ilya Glezerman
- Renal Service, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, New York, USA
- Shveta S Motwani
- Dana-Farber Cancer Institute Survivorship Program, Boston, Massachusetts, USA
- Naoka Murakami
- Division of Renal Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA
- Rimda Wanchoo
- Division of Kidney Diseases and Hypertension, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, New York, USA
- David I Ortiz-Melo
- Division of Nephrology, Duke University School of Medicine, Durham, North Carolina, USA
- Arash Rashidi
- Division of Nephrology and Hypertension, University Hospital Cleveland Medical Center, Cleveland, Ohio, USA
- Ben Sprangers
- Department of Microbiology, Immunology and Transplantation, Laboratory of Molecular Immunology (Rega Institute for Medical Research), KU Leuven, Leuven, Belgium
- Vikram Aggarwal
- Department of Nephrology and Hypertension, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- A Bilal Malik
- Division of Nephrology, University of Washington, Seattle, Washington, USA
- Sebastian Loew
- Department of Nephrology and Medical Intensive Care, Charité – Universitätsmedizin Berlin, Berlin, Germany
- Christopher A Carlos
- Division of Nephrology, Department of Medicine, University of California San Francisco, San Francisco, California, USA
- Pazit Beckerman
- Institute of Nephrology and Hypertension, Sheba Medical Center and Sackler School of Medicine, Tel Aviv University, Tel Hashomer, Tel Aviv, Israel
- Zain Mithani
- Katz Family Division of Nephrology and Hypertension, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida, USA
- Chintan V Shah
- Division of Nephrology, Hypertension, and Renal Transplant, Department of Medicine, University of Florida, Gainesville, Florida, USA
- Amanda D Renaghan
- Division of Nephrology, University of Virginia Health System, Charlottesville, Virginia, USA
- Sophie De Seigneux
- Service of Nephrology, Department of Medicine, University Hospitals of Geneva, Geneve, Switzerland
- Luca Campedel
- Department of Medical Oncology, Assistance Publique - Hopitaux de Paris, Paris, France
- Daniel Sanghoon Shin
- Division of Hematology-Oncology, VAGLAHS, Department of Medicine, David Geffen School of Medicine at University of California-Los Angeles, Los Angeles, California, USA
- Sunil Rangarajan
- Division of Hematology/Oncology and Division of Nephrology, The University of Alabama School of Medicine, Birmingham, Alabama, USA
- Priya Deshpande
- Division of Nephrology, Department of Medicine, Icahn School of Medicine at the Mount Sinai Hospital, New York, New York, USA
- Gaia Coppock
- Renal-Electrolyte and Hypertension Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Dwight H. Owen
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University, Columbus, Ohio, USA
- Marium Husain
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University, Columbus, Ohio, USA
- Clara Garcia-Carro
- Nephrology Department, Vall d’Hebron University Hospital, Vall d`Hebron Institute of Research, Barcelona, Spain
- Sheila Bermejo
- Nephrology Department, Vall d’Hebron University Hospital, Vall d`Hebron Institute of Research, Barcelona, Spain
- Nuttha Lumlertgul
- Department of Critical Care & Nephrology, Guy’s and St Thomas Hospital, London, UK
- Nina Seylanova
- Department of Critical Care & Nephrology, Guy’s and St Thomas Hospital, London, UK
- Busra Isik
- Division of Nephrology & Hypertension, Mayo Clinic, Rochester, Minnesota, USA
- Aydin Kaghazchi
- Division of Epidemiology and Population Health, Stanford University, Palo Alto, California, USA
- Yuriy Khanin
- Division of Kidney Diseases and Hypertension, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, New York, USA
- Sheru K Kansal
- Division of Nephrology and Hypertension, University Hospital Cleveland Medical Center, Cleveland, Ohio, USA
- Kai M Schmidt-Ott
- Department of Nephrology and Medical Intensive Care, Charité – Universitätsmedizin Berlin, Berlin, Germany
- Raymond K Hsu
- Division of Nephrology, Department of Medicine, University of California San Francisco, San Francisco, California, USA
- Maria C Tio
- Division of Renal Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA
- Suraj Sarvode Mothi
- Division of Renal Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA
- Harkarandeep Singh
- Division of Renal Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA
- Kenar D Jhaveri
- Division of Kidney Diseases and Hypertension, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, New York, USA
- David E Leaf
- Division of Renal Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA
- Corinne Isnard Bagnis
- Suraj S Mothi
- Weiting Chang
- Vipulbhai Sakhiya
- Daniel Stalbow
- Sylvia Wu
- Armando Cennamo
- Anne Rigg
- Nisha Shaunak
- Zoe A Kibbelaar
- Harish S Seethapathy
- Meghan Lee
- Ian A Strohbhen
- Ilya G Glezerman
- Dwight H Owen
- Sharon Mini
- Andrey Kisel
- Nicole Albert
- Katherine Carter
- Vicki Donley
- Tricia Young
- Heather Cigoi
- Els Wauters Ben Sprangers
- Javier A Pagan
- Jonathan J Hogan
- Valda Page
- Samuel AP Short
- A Bilal Malik
- Maria Josep Carreras
- DOI
- https://doi.org/10.1136/jitc-2021-003467
- Journal volume & issue
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Vol. 9,
no. 10
Abstract
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.
