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Acute kidney injury as a risk factor for mortality in oncological patients receiving checkpoint inhibitors

Clara García-Carro1, Mónica Bolufer1, Roxana Bury1

  • 1Nephrology Department, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Research, Barcelona, Spain.

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|February 6, 2021
PubMed
Abstract

Insights

Checkpoint inhibitors (CPIs) improve cancer outcomes but can cause acute kidney injury (AKI). Age and baseline kidney function predict AKI development, and AKI increases mortality risk in immunotherapy patients.

Area of Science:

  • Oncology
  • Nephrology
  • Immunology

Background:

  • Checkpoint inhibitors (CPIs) have revolutionized metastatic cancer treatment.
  • Immunotherapy with CPIs is linked to toxicities, notably acute kidney injury (AKI).
  • Limited data exist on CPI-related AKI risk factors, clinical features, and mortality impact.

Purpose of the Study:

  • To identify risk factors for CPI-related AKI.
  • To characterize the clinical presentation of CPI-related AKI.
  • To determine the impact of CPI-related AKI on patient mortality.

Main Methods:

  • Retrospective analysis of 759 patients receiving CPIs between March 2018 and April 2020.
  • Data collection included demographics, clinical details, and laboratory values.
  • AKI diagnosis followed KDIGO guidelines; logistic regression and survival analysis were used.

Main Results:

  • 15.5% of patients developed AKI.
  • Independent risk factors for AKI included older age and poorer baseline kidney function.
  • Mortality risk was associated with specific cancer types, CPI types, and the occurrence of AKI.

Conclusions:

  • Age and baseline renal function are key predictors of CPI-related AKI.
  • A single episode of AKI independently elevates mortality risk in patients undergoing immunotherapy.
  • Understanding these factors is crucial for managing immunotherapy-related toxicities.
Keywords:
acute kidney injurycheckpoint inhibitorsmortalityonconephrology

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