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免疫检查点抑制剂治疗后的蛋白尿:病例对照观察研究。

Proteinuria following administration of immune check point inhibitor: a case-control observational study.

机构信息

Department of Nephrology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China.

Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China.

出版信息

BMC Nephrol. 2024 Nov 27;25(1):429. doi: 10.1186/s12882-024-03868-5.

Abstract

PURPOSE

Proteinuria during treatment of immune checkpoint inhibitors (ICIs) was another renal adverse event besides from acute kidney injury. We aim to investigate the incidence and associated factors of proteinuria associated with ICIs.

METHOD

A case-control observational study about ICIs-treated cancer patients was conducted. Clinical and laboratory data at the baseline and during the follow-up was collected. Patients developed proteinuria during ICIs-treatment were classified to the proteinuria group.

RESULTS

Between March 2019 and August 2022, 440 patients were included in the study. Forty-eight patients (10.9%) developed proteinuria after ICIs-treatment. The occurrence of acute kidney injury between the proteinuria group and the control showed no difference[1(2.1%) vs. 9(2.3%), p = 1.000]. By multivariable logistic analysis, accumulative cycle of ICIs-administration (OR 1.079, 95% CI 1.033 to 1.127, p = 0.001) and comorbidity of liver cirrhosis (OR 2.198, 95% CI 1.082 to 4.468, p = 0.030) were associated with occurrence of proteinuria after ICIs-treatment independently.

CONCLUSIONS

Proteinuria could develop during the course of ICIs-therapy. Urinalysis should be monitored, especially for patients received multi-cycle of ICIs-administration and comorbid with liver cirrhosis.

摘要

目的

免疫检查点抑制剂(ICIs)治疗期间的蛋白尿是除急性肾损伤以外的另一种肾脏不良事件。本研究旨在探讨与 ICI 相关的蛋白尿的发生率和相关因素。

方法

对接受 ICI 治疗的癌症患者进行了一项病例对照观察性研究。收集了基线和随访期间的临床和实验室数据。将 ICI 治疗期间发生蛋白尿的患者分为蛋白尿组。

结果

2019 年 3 月至 2022 年 8 月,共纳入 440 例患者。48 例(10.9%)在接受 ICI 治疗后出现蛋白尿。蛋白尿组和对照组之间急性肾损伤的发生无差异[1(2.1%)比 9(2.3%),p=1.000]。多变量逻辑分析显示,ICIs 给药累积周期(OR 1.079,95%CI 1.033 至 1.127,p=0.001)和肝硬化合并症(OR 2.198,95%CI 1.082 至 4.468,p=0.030)与 ICI 治疗后蛋白尿的发生独立相关。

结论

蛋白尿可能在 ICI 治疗过程中发生。应监测尿液分析,特别是对于接受多周期 ICI 给药和合并肝硬化的患者。

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