Abstract: FR-PO198
Impact of Immune Checkpoint Inhibitors on AKI Incidence and Mortality in Patients with Bladder Cancer: A Single-Center Experience
Session Information
- Onconephrology: Immunotherapy Nephrotoxicity and Assessment of GFR
October 25, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Onconephrology
- 1700 Onconephrology
Authors
- Lee, Shina, Ewha Womens University Mokdong Hospital, Seoul, Korea (the Republic of)
- Kim, Seung-Jung, Ewha Womens University Mokdong Hospital, Seoul, Korea (the Republic of)
Background
Immune checkpoint inhibitors (ICPi) have increasingly become a therapeutic option for bladder cancer. Among bladder cancer patients, ICPi-associated acute kidney injury (AKI) has emerged as a significant toxicity. This study aims to describe the incidence, risk factors, renal outcomes, and mortality of AKI in patients receiving ICPi.
Methods
Patients who received ICPi between January 2021 and December 2021 at a single institution were retrospectively identified using the electronic medical database. AKI was defined as an increase in serum creatinine of ≥1.5 times the baseline value, based on the Kidney Disease: Improving Global Outcomes criteria. Cox proportional hazard regression analysis was used to assess risk factors for AKI and to evaluate the relationship between AKI and mortality.
Results
Among 108 patients with bladder cancer receiving checkpoint inhibitors, the overall incidence of AKI was 55.6%. Half of all AKI cases were associated with checkpoint inhibitors. Checkpoint inhibitor-associated AKI was mostly low-grade and occurred a median of 2 months after initiating the checkpoint inhibitors. AKI stage, the period from ICPi initiation to AKI occurrence, and the use of H2 blockers differed significantly between the non-ICPi AKI group and the ICPi-AKI group. However, the presence of all-cause AKI or checkpoint inhibitor-associated AKI did not lead to increased mortality.
Conclusion
This study shows that AKI frequently occurs in bladder cancer patients receiving ICPi. However, the presence of all-cause AKI and AKI related to ICPi toxicity did not increase mortality in these patients.
Cox proportional hazard regression analysis of relationship between AKI group and mortality.
| Crude | Adjusted | |
| HR (95%CI) | HR (95%CI) | |
| No AKI | Reference | Reference |
| AKI development | 55.2(0.25 - 1217) | 0.91 (0.80-1.04) |
| ICPi related AKI | 2.52 (0.67 - 9.39) | 0.27 (0.05 - 1.42) |
| Non ICPi related AKI | 2.94 (0.79 - 11.0) | 3.06 (0.70 - 18.5) |