RT Journal Article SR Electronic T1 Acute kidney injury in patients treated with immune checkpoint inhibitors JF Journal for ImmunoTherapy of Cancer JO J Immunother Cancer FD BMJ Publishing Group Ltd SP e003467 DO 10.1136/jitc-2021-003467 VO 9 IS 10 A1 Shruti Gupta A1 Samuel A P Short A1 Meghan E Sise A1 Jason M Prosek A1 Sethu M Madhavan A1 Maria Jose Soler A1 Marlies Ostermann A1 Sandra M Herrmann A1 Ala Abudayyeh A1 Shuchi Anand A1 Ilya Glezerman A1 Shveta S Motwani A1 Naoka Murakami A1 Rimda Wanchoo A1 David I Ortiz-Melo A1 Arash Rashidi A1 Ben Sprangers A1 Vikram Aggarwal A1 A Bilal Malik A1 Sebastian Loew A1 Christopher A Carlos A1 Wei-Ting Chang A1 Pazit Beckerman A1 Zain Mithani A1 Chintan V Shah A1 Amanda D Renaghan A1 Sophie De Seigneux A1 Luca Campedel A1 Abhijat Kitchlu A1 Daniel Sanghoon Shin A1 Sunil Rangarajan A1 Priya Deshpande A1 Gaia Coppock A1 Mark Eijgelsheim A1 Harish Seethapathy A1 Meghan D Lee A1 Ian A Strohbehn A1 Dwight H. Owen A1 Marium Husain A1 Clara Garcia-Carro A1 Sheila Bermejo A1 Nuttha Lumlertgul A1 Nina Seylanova A1 Lucy Flanders A1 Busra Isik A1 Omar Mamlouk A1 Jamie S Lin A1 Pablo Garcia A1 Aydin Kaghazchi A1 Yuriy Khanin A1 Sheru K Kansal A1 Els Wauters A1 Sunandana Chandra A1 Kai M Schmidt-Ott A1 Raymond K Hsu A1 Maria C Tio A1 Suraj Sarvode Mothi A1 Harkarandeep Singh A1 Deborah Schrag A1 Kenar D Jhaveri A1 Kerry L Reynolds A1 Frank B Cortazar A1 David E Leaf A1 , YR 2021 UL http://jitc.bmj.com/content/9/10/e003467.abstract AB 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.