Acute kidney injury in patients with cancer receiving anti-PD-1/PD-L1 antibodies: incidence, risk factors, and prognosis

AbstractAnti-PD-1/PD-L1 antibodies are widely used in anti-cancer therapy. While they have improved cancer prognoses, immune-related adverse events, which can cause acute kidney injury (AKI), cannot be ignored. The purpose of this retrospective cohort study was to assess the incidence, risk factors,...

Full description

Bibliographic Details
Main Authors: Qianqian Lou, Jianguang Gong, Binxian Ye, Rizhen Yu, Shuangshan Bu, Yiwen Li, Bin Zhu, Lina Shao
Format: Article
Language:English
Published: Taylor & Francis Group 2023-12-01
Series:Renal Failure
Subjects:
Online Access:https://www.tandfonline.com/doi/10.1080/0886022X.2023.2238823
_version_ 1797658489704677376
author Qianqian Lou
Jianguang Gong
Binxian Ye
Rizhen Yu
Shuangshan Bu
Yiwen Li
Bin Zhu
Lina Shao
author_facet Qianqian Lou
Jianguang Gong
Binxian Ye
Rizhen Yu
Shuangshan Bu
Yiwen Li
Bin Zhu
Lina Shao
author_sort Qianqian Lou
collection DOAJ
description AbstractAnti-PD-1/PD-L1 antibodies are widely used in anti-cancer therapy. While they have improved cancer prognoses, immune-related adverse events, which can cause acute kidney injury (AKI), cannot be ignored. The purpose of this retrospective cohort study was to assess the incidence, risk factors, and prognosis of AKI associated with anti-PD-1/PD-L1 antibodies. Patients who received anti-PD-1/PD-L1 antibody treatment at our hospital between January 2018 and December 2022 were enrolled. Clinical information, combined medications, concomitant diseases, tumor types, and laboratory indicators were collected from patient records, and the incidence of AKI was determined. The risk factors for AKI were assessed using univariate and multivariate logistic regression analyses. Overall, 1418 patients were enrolled. The median follow-up time was 112 days and 92 (6.5%) developed AKI. The median time from the initial anti-PD-1/PD-L1 antibody treatment to AKI was 99.85 days. Head and neck cancer and combined use of diuretics, non-steroidal anti-inflammatory drugs (NSAIDs), lower hemoglobin level, and other types of chemotherapeutic drugs were independent risk factors for AKI. The complete recovery, partial recovery, non-recovery, and unknown AKI rates were 7.6%, 28.3%, 52.2%, and 11.9%, respectively. Kidney biopsies were performed on two patients with AKI and pathology confirmed diagnosis of acute tubulointerstitial nephritis. In this cohort, AKI was not uncommon in patients treated with anti-PD-1/PD-L1 antibodies; therefore, it is necessary to monitor renal function and identify AKI early, especially in patients with head and neck tumors. Improving anemia and minimizing the use of diuretics, NSAIDs, and chemotherapeutics may reduce AKI.
first_indexed 2024-03-11T17:59:41Z
format Article
id doaj.art-1eca84a839a3487d8ed4b5b59f180af0
institution Directory Open Access Journal
issn 0886-022X
1525-6049
language English
last_indexed 2024-03-11T17:59:41Z
publishDate 2023-12-01
publisher Taylor & Francis Group
record_format Article
series Renal Failure
spelling doaj.art-1eca84a839a3487d8ed4b5b59f180af02023-10-17T09:23:23ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492023-12-0145110.1080/0886022X.2023.2238823Acute kidney injury in patients with cancer receiving anti-PD-1/PD-L1 antibodies: incidence, risk factors, and prognosisQianqian Lou0Jianguang Gong1Binxian Ye2Rizhen Yu3Shuangshan Bu4Yiwen Li5Bin Zhu6Lina Shao7Department of Nephrology, Dongyang Hospital (Affiliated Wenzhou University), Zhejiang, ChinaUrology & Nephrology Center, Department of Nephrology, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, Hangzhou, ChinaUrology & Nephrology Center, Department of Nephrology, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, Hangzhou, ChinaUrology & Nephrology Center, Department of Nephrology, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, Hangzhou, ChinaDepartment of Nephrology, Dongyang Hospital (Affiliated Wenzhou University), Zhejiang, ChinaUrology & Nephrology Center, Department of Nephrology, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, Hangzhou, ChinaUrology & Nephrology Center, Department of Nephrology, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, Hangzhou, ChinaUrology & Nephrology Center, Department of Nephrology, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, Hangzhou, ChinaAbstractAnti-PD-1/PD-L1 antibodies are widely used in anti-cancer therapy. While they have improved cancer prognoses, immune-related adverse events, which can cause acute kidney injury (AKI), cannot be ignored. The purpose of this retrospective cohort study was to assess the incidence, risk factors, and prognosis of AKI associated with anti-PD-1/PD-L1 antibodies. Patients who received anti-PD-1/PD-L1 antibody treatment at our hospital between January 2018 and December 2022 were enrolled. Clinical information, combined medications, concomitant diseases, tumor types, and laboratory indicators were collected from patient records, and the incidence of AKI was determined. The risk factors for AKI were assessed using univariate and multivariate logistic regression analyses. Overall, 1418 patients were enrolled. The median follow-up time was 112 days and 92 (6.5%) developed AKI. The median time from the initial anti-PD-1/PD-L1 antibody treatment to AKI was 99.85 days. Head and neck cancer and combined use of diuretics, non-steroidal anti-inflammatory drugs (NSAIDs), lower hemoglobin level, and other types of chemotherapeutic drugs were independent risk factors for AKI. The complete recovery, partial recovery, non-recovery, and unknown AKI rates were 7.6%, 28.3%, 52.2%, and 11.9%, respectively. Kidney biopsies were performed on two patients with AKI and pathology confirmed diagnosis of acute tubulointerstitial nephritis. In this cohort, AKI was not uncommon in patients treated with anti-PD-1/PD-L1 antibodies; therefore, it is necessary to monitor renal function and identify AKI early, especially in patients with head and neck tumors. Improving anemia and minimizing the use of diuretics, NSAIDs, and chemotherapeutics may reduce AKI.https://www.tandfonline.com/doi/10.1080/0886022X.2023.2238823Anti-PD-1/PD-L1 antibodiesacute kidney injurycancerrisk factorsprognosis
spellingShingle Qianqian Lou
Jianguang Gong
Binxian Ye
Rizhen Yu
Shuangshan Bu
Yiwen Li
Bin Zhu
Lina Shao
Acute kidney injury in patients with cancer receiving anti-PD-1/PD-L1 antibodies: incidence, risk factors, and prognosis
Renal Failure
Anti-PD-1/PD-L1 antibodies
acute kidney injury
cancer
risk factors
prognosis
title Acute kidney injury in patients with cancer receiving anti-PD-1/PD-L1 antibodies: incidence, risk factors, and prognosis
title_full Acute kidney injury in patients with cancer receiving anti-PD-1/PD-L1 antibodies: incidence, risk factors, and prognosis
title_fullStr Acute kidney injury in patients with cancer receiving anti-PD-1/PD-L1 antibodies: incidence, risk factors, and prognosis
title_full_unstemmed Acute kidney injury in patients with cancer receiving anti-PD-1/PD-L1 antibodies: incidence, risk factors, and prognosis
title_short Acute kidney injury in patients with cancer receiving anti-PD-1/PD-L1 antibodies: incidence, risk factors, and prognosis
title_sort acute kidney injury in patients with cancer receiving anti pd 1 pd l1 antibodies incidence risk factors and prognosis
topic Anti-PD-1/PD-L1 antibodies
acute kidney injury
cancer
risk factors
prognosis
url https://www.tandfonline.com/doi/10.1080/0886022X.2023.2238823
work_keys_str_mv AT qianqianlou acutekidneyinjuryinpatientswithcancerreceivingantipd1pdl1antibodiesincidenceriskfactorsandprognosis
AT jianguanggong acutekidneyinjuryinpatientswithcancerreceivingantipd1pdl1antibodiesincidenceriskfactorsandprognosis
AT binxianye acutekidneyinjuryinpatientswithcancerreceivingantipd1pdl1antibodiesincidenceriskfactorsandprognosis
AT rizhenyu acutekidneyinjuryinpatientswithcancerreceivingantipd1pdl1antibodiesincidenceriskfactorsandprognosis
AT shuangshanbu acutekidneyinjuryinpatientswithcancerreceivingantipd1pdl1antibodiesincidenceriskfactorsandprognosis
AT yiwenli acutekidneyinjuryinpatientswithcancerreceivingantipd1pdl1antibodiesincidenceriskfactorsandprognosis
AT binzhu acutekidneyinjuryinpatientswithcancerreceivingantipd1pdl1antibodiesincidenceriskfactorsandprognosis
AT linashao acutekidneyinjuryinpatientswithcancerreceivingantipd1pdl1antibodiesincidenceriskfactorsandprognosis