TY - JOUR T1 - Acute kidney injury in patients treated with immune checkpoint inhibitors JF - Journal for ImmunoTherapy of Cancer JO - J Immunother Cancer DO - 10.1136/jitc-2021-003467 VL - 9 IS - 10 SP - e003467 AU - Shruti Gupta AU - Samuel A P Short AU - Meghan E Sise AU - Jason M Prosek AU - Sethu M Madhavan AU - Maria Jose Soler AU - Marlies Ostermann AU - Sandra M Herrmann AU - Ala Abudayyeh AU - Shuchi Anand AU - Ilya Glezerman AU - Shveta S Motwani AU - Naoka Murakami AU - Rimda Wanchoo AU - David I Ortiz-Melo AU - Arash Rashidi AU - Ben Sprangers AU - Vikram Aggarwal AU - A Bilal Malik AU - Sebastian Loew AU - Christopher A Carlos AU - Wei-Ting Chang AU - Pazit Beckerman AU - Zain Mithani AU - Chintan V Shah AU - Amanda D Renaghan AU - Sophie De Seigneux AU - Luca Campedel AU - Abhijat Kitchlu AU - Daniel Sanghoon Shin AU - Sunil Rangarajan AU - Priya Deshpande AU - Gaia Coppock AU - Mark Eijgelsheim AU - Harish Seethapathy AU - Meghan D Lee AU - Ian A Strohbehn AU - Dwight H. Owen AU - Marium Husain AU - Clara Garcia-Carro AU - Sheila Bermejo AU - Nuttha Lumlertgul AU - Nina Seylanova AU - Lucy Flanders AU - Busra Isik AU - Omar Mamlouk AU - Jamie S Lin AU - Pablo Garcia AU - Aydin Kaghazchi AU - Yuriy Khanin AU - Sheru K Kansal AU - Els Wauters AU - Sunandana Chandra AU - Kai M Schmidt-Ott AU - Raymond K Hsu AU - Maria C Tio AU - Suraj Sarvode Mothi AU - Harkarandeep Singh AU - Deborah Schrag AU - Kenar D Jhaveri AU - Kerry L Reynolds AU - Frank B Cortazar AU - David E Leaf A2 - , Y1 - 2021/10/01 UR - http://jitc.bmj.com/content/9/10/e003467.abstract N2 - 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. ER -