%0 Journal Article %A Shruti Gupta %A Samuel A P Short %A Meghan E Sise %A Jason M Prosek %A Sethu M Madhavan %A Maria Jose Soler %A Marlies Ostermann %A Sandra M Herrmann %A Ala Abudayyeh %A Shuchi Anand %A Ilya Glezerman %A Shveta S Motwani %A Naoka Murakami %A Rimda Wanchoo %A David I Ortiz-Melo %A Arash Rashidi %A Ben Sprangers %A Vikram Aggarwal %A A Bilal Malik %A Sebastian Loew %A Christopher A Carlos %A Wei-Ting Chang %A Pazit Beckerman %A Zain Mithani %A Chintan V Shah %A Amanda D Renaghan %A Sophie De Seigneux %A Luca Campedel %A Abhijat Kitchlu %A Daniel Sanghoon Shin %A Sunil Rangarajan %A Priya Deshpande %A Gaia Coppock %A Mark Eijgelsheim %A Harish Seethapathy %A Meghan D Lee %A Ian A Strohbehn %A Dwight H. Owen %A Marium Husain %A Clara Garcia-Carro %A Sheila Bermejo %A Nuttha Lumlertgul %A Nina Seylanova %A Lucy Flanders %A Busra Isik %A Omar Mamlouk %A Jamie S Lin %A Pablo Garcia %A Aydin Kaghazchi %A Yuriy Khanin %A Sheru K Kansal %A Els Wauters %A Sunandana Chandra %A Kai M Schmidt-Ott %A Raymond K Hsu %A Maria C Tio %A Suraj Sarvode Mothi %A Harkarandeep Singh %A Deborah Schrag %A Kenar D Jhaveri %A Kerry L Reynolds %A Frank B Cortazar %A David E Leaf %A , %T Acute kidney injury in patients treated with immune checkpoint inhibitors %D 2021 %R 10.1136/jitc-2021-003467 %J Journal for ImmunoTherapy of Cancer %P e003467 %V 9 %N 10 %X 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.All data relevant to the study are included in the article or uploaded as supplementary information. %U https://jitc.bmj.com/content/jitc/9/10/e003467.full.pdf