Renal adverse effects of immune checkpoints inhibitors in clinical practice: ImmuNoTox study

Acute Kidney Injury (AKI), induced by Checkpoint Inhibitors therapies (CPI-induced AKI), is an uncommon but severe Immune-Related Adverse Event (IRAE). The aim was to describe the epidemiology, risks factors, clinical, and laboratory characteristics of these renal adverse events (AEs) in a real-life...

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Bibliographic Details
Published in:European journal of cancer (1990) 2021-04, Vol.147, p.29-39
Main Authors: Espi, M., Teuma, C., Novel-Catin, E., Maillet, D., Souquet, P.J., Dalle, S., Koppe, L., Fouque, D.
Format: Article
Language:English
Subjects:
Acute kidney injury
Adverse events
Adverse renal events
Cancer
Checkpoint inhibitors
Corticosteroids
Creatinine
Epidemiology
Epidermal growth factor receptors
Glomerular filtration rate
Health services
Histology
Immune checkpoint
Inhibitors
IRAEs
Kidney diseases
Kidneys
Life Sciences
Nephritis
Nephrology
Patients
Renal function
Risk factors
Therapy
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Summary:Acute Kidney Injury (AKI), induced by Checkpoint Inhibitors therapies (CPI-induced AKI), is an uncommon but severe Immune-Related Adverse Event (IRAE). The aim was to describe the epidemiology, risks factors, clinical, and laboratory characteristics of these renal adverse events (AEs) in a real-life cohort treatment. Consecutive patients undergoing a checkpoint inhibitor (CPI) therapy at the Hôpital Lyon Sud from January 2015 to July 2017 were included. A systematic retrospective analysis of medical files was performed, monthly serum creatinine levels, associated treatments, and occurrence of other IRAEs data were collected. AKI episodes explained by classic AKI aetiologies (prerenal, obstructive, septic) were excluded from the analysis. CPI-induced AKI incidence was 3.7% (13/352) and appeared to be time-dependent (7.7% (11/143) for patients with >3 months of CPI exposure), ranging from 1 to 16 months. All cases with available histology were acute tubulointerstitial nephritis (ATIN), with poor urinary sediment. The severity of AKI was mild (stage 1 in 50% of cases), with no need for renal-replacement therapy. Although CPI-induced AKI patients had more frequently other IRAEs (77% versus 39%), this was not associated with a greater risk of AKI. Pre-existing chronic kidney disease (defined as an estimated glomerular filtration rate (eGFR)
ISSN:0959-8049
1879-0852
DOI:10.1016/j.ejca.2021.01.005