Zhou Ping, Liu Bing, Shen Ning, Fan Xiaoting, Lu Shangwei, Kong Zhijuan, Gao Ying, Lv Zhimei, Wang Rong
Department of Nephrology, Shandong Provincial Hospital, Shandong University, Jinan, China.
Department of Nephrology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.
Ren Fail. 2024 Dec;46(1):2326186. doi: 10.1080/0886022X.2024.2326186. Epub 2024 Mar 11.
Immune checkpoint inhibitor-associated acute kidney injury (ICI-AKI) is the most common renal complication and has attracted increasing amounts of attention. However, studies on this topic in Chinese cancer patients are very limited. Therefore, we conducted a retrospective study on the incidence, risk factors, clinical features and renal recovery of ICI-AKI in all patients with malignancies treated with ICIs in Shandong Provincial Hospital Affiliated to Shandong First Medical University.
In this single-center retrospective cohort study, the data of 904 patients who received immune checkpoint inhibitors (ICIs) treatment were retrospectively analyzed. Multivariable logistic regression was used to identify the predictors of ICI-AKI.
A total of 46 of 904 patients receiving ICIs developed ICI-AKI, and the incidence of ICI-AKI was 5.1%. Patients developed ICI-AKI at a median of 9 weeks (IQR 3-23) after ICIs initiation. A lower baseline estimated glomerular filtration rate (eGFR) and use of antibiotics were associated with a higher risk of ICI-AKI. Renal recovery occurred in 17 patients (46%) at a median of 4 weeks (IQR 2-8) after ICI-AKI, including 16 (43%) with complete recovery and 1 (3%) with partial recovery. Of the 14 rechallenged patients, only one developed recurrent ICI-AKI.
Patients with ICI-AKI were more likely to have impaired renal function at baseline and after treatment with antibiotics. Approximately half of the patients achieved renal recovery.
免疫检查点抑制剂相关急性肾损伤（ICI-AKI）是最常见的肾脏并发症，已引起越来越多的关注。然而，针对中国癌症患者这一主题的研究非常有限。因此，我们对山东第一医科大学附属山东省立医院所有接受免疫检查点抑制剂（ICIs）治疗的恶性肿瘤患者的ICI-AKI发病率、危险因素、临床特征及肾脏恢复情况进行了一项回顾性研究。
在这项单中心回顾性队列研究中，对904例接受免疫检查点抑制剂（ICIs）治疗的患者的数据进行了回顾性分析。采用多变量逻辑回归分析来确定ICI-AKI的预测因素。
904例接受ICIs治疗的患者中，共有46例发生了ICI-AKI，ICI-AKI的发病率为5.1%。患者在开始使用ICIs后中位9周（IQR 3-23）发生ICI-AKI。较低的基线估计肾小球滤过率（eGFR）和使用抗生素与发生ICI-AKI的较高风险相关。17例患者（46%）在发生ICI-AKI后中位4周（IQR 2-8）实现了肾脏恢复，其中16例（43%）完全恢复，1例（3%）部分恢复。在14例再次接受治疗的患者中，只有1例发生了复发性ICI-AKI。
发生ICI-AKI的患者在基线时以及使用抗生素治疗后肾功能更有可能受损。约一半的患者实现了肾脏恢复。
