410P - The incidence and risk factors of kidney injury in patients receiving immune checkpoint inhibitors: A retrospective observational cohort study

Background

Immune checkpoint inhibitors (ICPis) are approved for many cancer treatments. However, they were associated with the occurrence of immune-related adverse events (irAEs). Though kidney irAEs are less frequently reported than other irAEs, they can affect the cancer treatment strategy. This study evaluated the incidence and risk factors of kidney injury in patients receiving ICPis.

Methods

We included all cancer patients who received ICPis from January 2014 to December 2021 at King Chulalongkorn Memorial Hospital. Kidney injury was defined as a ≥ 1.5-fold increase in serum creatinine from baseline.

Results

This study recruits 265 eligible patients. The overall cumulative incidence of kidney injury (over three years) was 9.4% (95% CI =6.4% to 13.8%) for patients initiating ICPis therapy for any cancer. Most of the patients were male (68.3%), median age was 62 (56-70) years, baseline serum creatinine was 0.8 (0.7-1) mg/dl, and eGFR CKD-EPI was 94.2 (77.1-107.1) min/mL/1.73m². This study showed eGFR CKD-EPI< 90 min/mL/1.73m2 (HR 3.79; 95% CI 1.39-10.36;p 0.01), diabetes mellitus (HR 3.66; 95%CI 1.59-8.45;p=0.002), cerebrovascular disease (HR 13.08; 95%CI 3.57-47.88;p<0.001), hepatocellular carcinoma (HR 2.8; 95%CI 1.12-6.98;p=0.03), and concurrent used of antibiotics (HR 3.58; 95%CI 1.39-9.21;p=0.01) were significantly associated with a higher risk of kidney injury. The cause of kidney injury is hemodynamic kidney injury (70.8%), ICPis-related kidney injury (20.8%), and obstructive kidney injury (8.3%).

Conclusions

Patients receiving ICPis frequently developed kidney injury. Kidney function needs to be monitored in high-risk patients.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.