期刊
EUROPEAN JOURNAL OF CANCER
卷 157, 期 -, 页码 50-58出版社
ELSEVIER SCI LTD
DOI: 10.1016/j.ejca.2021.07.031
关键词
Immune checkpoint inhibitor; Acute kidney injury; Chronic kidney disease
类别
资金
- National Institutes of Health (NIH) [K23 DK 117014]
- Claflin Distinguished Scholars Award
This study investigated the impact of immune checkpoint inhibitors on kidney function in patients with renal cell carcinoma and urothelial carcinoma. The results showed that acute kidney injury and sustained eGFR loss were common, and immune-related adverse events may be a novel risk factor for kidney function decline in patients receiving ICIs.
Background: In patients with genitourinary cancers, the effect of immune checkpoint inhibitors (ICIs) on kidney function is unknown. Patients and methods: This is a retrospective cohort study of patients with renal cell carcinoma (RCC) and urothelial carcinoma who received ICIs at two major cancer centers between 2012 and 2018. Cumulative incidence and Fine and Gray subdistribution hazard models were performed to determine predictors of the co-primary outcomes, (1) acute kidney injury (AKI) and (2) sustained estimated glomerular filtration rate (eGFR) loss, defined as a >20% decline in eGFR sustained >= 90 days. We also determined the association between immune-related adverse events (irAE) and adverse kidney outcomes among patients surviving >= 1 year. Results: 637 patients were included; 320 (50%) patients had RCC and 317 (50%) patients had urothelial carcinoma. Half of the cohort had eGFR<60 mL/min/1.73 m(2) at baseline. irAEs, AKI, and sustained eGFR loss were common, occurring in 33%, 25% and 16%, respectively. Compared to patients with urothelial carcinoma, patients with RCC were more likely to develop irAEs (aHR 1.61, 95% CI 1.20-2.18) and sustained eGFR loss (aHR 1.97, 95% CI 1.24-3.12), but not AKI (aHR 1.53, 95% CI 0.97-2.41). Among patients surviving >= 1 years, experiencing a non-renal irAE was associated with a significantly higher risk of sustained eGFR loss (aHR 1.71, 95% CI 1.14-2.57). Conclusion: AKI and sustained eGFR loss are common in patients with genitourinary cancers receiving ICIs. irAEs may be a novel risk factor for kidney function decline among patients receiving ICIs. (C) 2021 Elsevier Ltd. All rights reserved.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据