Ms Jessica Maccan2, Dr Peter Kolovos3, Dr Amanda Stevanovic1, Dr Bhadran Bose1,2, Dr Muralikrishna Gangadharan Komala1,2
1NBMLHD, Kingswood, Australia, 2Sydney University, Sydney, Australi, 3ISLHD, Wollongong, Australia
Background: Immune checkpoint inhibitors (CPI) have been associated with significant improvement in cancer outcomes. However, they are also associated with adverse renal events in a minority.
Aim: To determine the incidence of renal adverse events in patients treated with CPI and the outcomes of renal adverse events. To determine the risk factors predisposing patients to renal adverse events in patients treated with CPI.
Methods: A prospective single arm cohort study was designed. All patients aged above 18 with solid organ malignancies starting therapy with CPI from April 2020 were observed at baseline and followed up for a period of one year. Patients with Chronic kidney disease (CKD) 4 and above were excluded. Demographic data, concurrent medical conditions, medications, malignancy type, CPI type were recorded at baseline and during follow up. Two renal physicians determined the etiology of renal dysfunction as CPI related or unrelated. Univariate logistic regression was performed to identify patient characteristics associated with development of acute kidney injury (AKI). Kaplan-Meier was used to determine survival differences between those who did and did not develop AKI
Results: The incidence of CPI induced AKI was 2.9%. Multivariate analysis showed proton pump inhibitor (PPI) use to be associated with high risk of CPI induced AKI. There was a trend towards increased mortality in patients who developed AKI. However, there was no mortality in patients with CPI induced AKI.
Conclusion: Our single centre study showed that the incidence of renal events is minimal in patients treated with CPI. PPI use increased risk of AKI in these patients. CPI associated AKI is not associated with increased mortality.
Biography:
To come