Incidence and Clinical Features of Immune-Related Acute Kidney Injury in Patients Receiving Programmed Cell Death Ligand-1 Inhibitors
Background: Programmed cell death receptor ligand 1 (PD-L1) inhibitors are immune checkpoint inhibitors (ICIs) with a side effect profile that may differ from other classes of ICIs such as those directed against cytotoxic T-lymphocyte−associated protein 4 (CTLA-4) and programmed cell death 1 recepto...
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Format: | Article |
Language: | English |
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Elsevier
2020-10-01
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Series: | Kidney International Reports |
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Online Access: | http://www.sciencedirect.com/science/article/pii/S2468024920313760 |
id |
doaj-e8904d035ea34b23aca56820cb203d19 |
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record_format |
Article |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Harish Seethapathy Sophia Zhao Ian A. Strohbehn Meghan Lee Donald F. Chute Halla Bates Gabriel E. Molina Leyre Zubiri Shruti Gupta Shveta Motwani David E. Leaf Ryan J. Sullivan Osama Rahma Kimberly G. Blumenthal Alexandra-Chloe Villani Kerry L. Reynolds Meghan E. Sise |
spellingShingle |
Harish Seethapathy Sophia Zhao Ian A. Strohbehn Meghan Lee Donald F. Chute Halla Bates Gabriel E. Molina Leyre Zubiri Shruti Gupta Shveta Motwani David E. Leaf Ryan J. Sullivan Osama Rahma Kimberly G. Blumenthal Alexandra-Chloe Villani Kerry L. Reynolds Meghan E. Sise Incidence and Clinical Features of Immune-Related Acute Kidney Injury in Patients Receiving Programmed Cell Death Ligand-1 Inhibitors Kidney International Reports acute interstitial nephritis acute kidney injury immune checkpoint inhibitor immune-related adverse events PD-L1 inhibitors |
author_facet |
Harish Seethapathy Sophia Zhao Ian A. Strohbehn Meghan Lee Donald F. Chute Halla Bates Gabriel E. Molina Leyre Zubiri Shruti Gupta Shveta Motwani David E. Leaf Ryan J. Sullivan Osama Rahma Kimberly G. Blumenthal Alexandra-Chloe Villani Kerry L. Reynolds Meghan E. Sise |
author_sort |
Harish Seethapathy |
title |
Incidence and Clinical Features of Immune-Related Acute Kidney Injury in Patients Receiving Programmed Cell Death Ligand-1 Inhibitors |
title_short |
Incidence and Clinical Features of Immune-Related Acute Kidney Injury in Patients Receiving Programmed Cell Death Ligand-1 Inhibitors |
title_full |
Incidence and Clinical Features of Immune-Related Acute Kidney Injury in Patients Receiving Programmed Cell Death Ligand-1 Inhibitors |
title_fullStr |
Incidence and Clinical Features of Immune-Related Acute Kidney Injury in Patients Receiving Programmed Cell Death Ligand-1 Inhibitors |
title_full_unstemmed |
Incidence and Clinical Features of Immune-Related Acute Kidney Injury in Patients Receiving Programmed Cell Death Ligand-1 Inhibitors |
title_sort |
incidence and clinical features of immune-related acute kidney injury in patients receiving programmed cell death ligand-1 inhibitors |
publisher |
Elsevier |
series |
Kidney International Reports |
issn |
2468-0249 |
publishDate |
2020-10-01 |
description |
Background: Programmed cell death receptor ligand 1 (PD-L1) inhibitors are immune checkpoint inhibitors (ICIs) with a side effect profile that may differ from other classes of ICIs such as those directed against cytotoxic T-lymphocyte−associated protein 4 (CTLA-4) and programmed cell death 1 receptor (PD-1). Being the more recently approved class of checkpoint inhibitors, there are no studies investigating the frequency, etiology and predictors of acute kidney injury (AKI) in patients receiving PD-L1 inhibitors. Methods: This was a retrospective cohort study of patients who received PD-L1 inhibitors during 2017 to 2018 in our healthcare system. AKI was defined by a ≥1.5-fold rise in serum creatinine from baseline. The etiology of all cases of sustained AKI (lasting >48 hours) and clinical course were determined by review of electronic health records. Results: The final analysis included 599 patients. Within 12 months of ICI initiation, 104 patients (17%) experienced AKI, and 36 (6%) experienced sustained AKI; however, only 5 (<1%) experienced suspected PD-L1–related AKI. The PD-L1–related AKI occurred a median of 99 days after starting therapy. All patients concurrently received another medication known to cause acute interstitial nephritis (proton pump inhibitors, nonsteroidal anti-inflammatory drugs, or antibiotics) at the time of the suspected PDL1-related AKI. Conclusion: Although AKI is common in patients receiving PD-L1 therapy, the incidence of suspected PD-L1–related AKI is low (<1%) and may be less common when compared to other classes of ICIs. This cohort provides further validation that other drugs associated with acute interstitial nephritis may be involved in the pathogenesis of ICI-related AKI. |
topic |
acute interstitial nephritis acute kidney injury immune checkpoint inhibitor immune-related adverse events PD-L1 inhibitors |
url |
http://www.sciencedirect.com/science/article/pii/S2468024920313760 |
work_keys_str_mv |
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doaj-e8904d035ea34b23aca56820cb203d192020-11-25T03:06:50ZengElsevierKidney International Reports2468-02492020-10-0151017001705Incidence and Clinical Features of Immune-Related Acute Kidney Injury in Patients Receiving Programmed Cell Death Ligand-1 InhibitorsHarish Seethapathy0Sophia Zhao1Ian A. Strohbehn2Meghan Lee3Donald F. Chute4Halla Bates5Gabriel E. Molina6Leyre Zubiri7Shruti Gupta8Shveta Motwani9David E. Leaf10Ryan J. Sullivan11Osama Rahma12Kimberly G. Blumenthal13Alexandra-Chloe Villani14Kerry L. Reynolds15Meghan E. Sise16Department of Medicine, Division of Nephrology, Massachusetts General Hospital, Boston, Massachusetts, USADepartment of Medicine, Division of Nephrology, Massachusetts General Hospital, Boston, Massachusetts, USADepartment of Medicine, Liver Center, Massachusetts General Hospital, Boston, Massachusetts, USADepartment of Medicine, Liver Center, Massachusetts General Hospital, Boston, Massachusetts, USADepartment of Medicine, Division of Nephrology, Massachusetts General Hospital, Boston, Massachusetts, USADepartment of Medicine, Division of Nephrology, Massachusetts General Hospital, Boston, Massachusetts, USADepartment of Medicine, Division of Hematology and Oncology, Massachusetts General Hospital, Boston, Massachusetts, USADepartment of Medicine, Division of Hematology and Oncology, Massachusetts General Hospital, Boston, Massachusetts, USADepartment of Medicine, Division of Renal Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USADepartment of Medicine, Division of Renal Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USADepartment of Medicine, Division of Renal Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USADepartment of Medicine, Division of Hematology and Oncology, Massachusetts General Hospital, Boston, Massachusetts, USADepartment of Medical Oncology, Dana Farber Cancer Institute, Boston, Massachusetts, USADepartment of Medicine, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, Massachusetts, USADepartment of Medicine, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, Massachusetts, USADepartment of Medicine, Division of Hematology and Oncology, Massachusetts General Hospital, Boston, Massachusetts, USADepartment of Medicine, Division of Nephrology, Massachusetts General Hospital, Boston, Massachusetts, USA; Correspondence: Meghan Sise, 165 Cambridge Street Suite 302, Boston, Massachusetts 02114, USA.Background: Programmed cell death receptor ligand 1 (PD-L1) inhibitors are immune checkpoint inhibitors (ICIs) with a side effect profile that may differ from other classes of ICIs such as those directed against cytotoxic T-lymphocyte−associated protein 4 (CTLA-4) and programmed cell death 1 receptor (PD-1). Being the more recently approved class of checkpoint inhibitors, there are no studies investigating the frequency, etiology and predictors of acute kidney injury (AKI) in patients receiving PD-L1 inhibitors. Methods: This was a retrospective cohort study of patients who received PD-L1 inhibitors during 2017 to 2018 in our healthcare system. AKI was defined by a ≥1.5-fold rise in serum creatinine from baseline. The etiology of all cases of sustained AKI (lasting >48 hours) and clinical course were determined by review of electronic health records. Results: The final analysis included 599 patients. Within 12 months of ICI initiation, 104 patients (17%) experienced AKI, and 36 (6%) experienced sustained AKI; however, only 5 (<1%) experienced suspected PD-L1–related AKI. The PD-L1–related AKI occurred a median of 99 days after starting therapy. All patients concurrently received another medication known to cause acute interstitial nephritis (proton pump inhibitors, nonsteroidal anti-inflammatory drugs, or antibiotics) at the time of the suspected PDL1-related AKI. Conclusion: Although AKI is common in patients receiving PD-L1 therapy, the incidence of suspected PD-L1–related AKI is low (<1%) and may be less common when compared to other classes of ICIs. This cohort provides further validation that other drugs associated with acute interstitial nephritis may be involved in the pathogenesis of ICI-related AKI.http://www.sciencedirect.com/science/article/pii/S2468024920313760acute interstitial nephritisacute kidney injuryimmune checkpoint inhibitorimmune-related adverse eventsPD-L1 inhibitors |