Kidney Week

Abstract: FR-PO038

Global Risk of AKI and Tubulointerstitial Nephritis following Anticancer Drug Administration, 1967-2023: Long-Term Pharmacovigilance Analysis

Session Information

• AKI: Epidemiology, Risk Factors, and Prevention - 2
  October 25, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Acute Kidney Injury

• 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

• Yoon, Soo-Young, Kyung Hee University Hospital, Dongdaemun-gu, Seoul, Korea (the Republic of)

Soo-Young Yoon, MD, PhD

• Kim, Dae Kyu, Kyung Hee University Hospital, Dongdaemun-gu, Seoul, Korea (the Republic of)

Dae Kyu Kim, MD

• Jung, Su Woong, Kyung Hee University Hospital at Gangdong, Gangdong-gu, Seoul, Korea (the Republic of)

Su Woong Jung, MD, PhD

• Kim, Jin Sug, Kyung Hee University Hospital, Dongdaemun-gu, Seoul, Korea (the Republic of)

Jin Sug Kim, MD, PhD

• Moon, Ju young, Kyung Hee University Hospital at Gangdong, Gangdong-gu, Seoul, Korea (the Republic of)

Ju young Moon, MD, PhD

• Hwang, Hyeon Seok, Kyung Hee University Hospital, Dongdaemun-gu, Seoul, Korea (the Republic of)

Hyeon Seok Hwang, MD, PhD

• Jeong, Kyunghwan, Kyung Hee University Hospital, Dongdaemun-gu, Seoul, Korea (the Republic of)

Kyunghwan Jeong, MD, PhD

Background

Various anticancer drugs are being used worldwide with the advancement of anticancer drugs. Anticancer agents may be nephrotoxic and the aim of this study was to analyze the global risk of renal adverse reactions based on different types of anticancer drugs.

Methods

Between December 1967 to July 2023, we analysed the association between different types of anticancer drugs and the risk of acute kidney injury (AKI) or tubulointerstitial nephritis (TIN) using the World Health Organization pharmacovigilance database. The effect size was assessed using the reporting odds ratio (ROR) through disproportionate Bayesian reporting method. The 306 anticancer drugs were classified into four groups: cytotoxic therapy, hormone therapy, immunotherapy, and targeted therapy.

Results

We identified 32,722 cases of AKI and 2,056 cases of TIN that were reported as renal adverse reactions related to anticancer drugs. Cytotoxic therapies consistently accounted for 13,925 cases, while AKI cases related to targeted therapies and immunotherapies increased to 14,236 and 3,816 cases, respectively, over three decades. The use of immunotherapy between 2015 and 2020 led to a significant increase in TIN, surpassing other categories of anticancer drugs. The highest disproportionality signal for AKI was associated with immunotherapies (ROR, 8.92; confidence interval [CI], 8.63–9.21, followed by cytotoxic therapies (ROR, 7.14; 95% CI, 7.01–7.26), targeted therapies (ROR, 5.83; 95% CI, 5.73–5.93), and hormone therapies (ROR, 2.59; 95% CI, 2.41–2.79). The analysis showed a significantly higher disproportionality signal for immunotherapies (ROR, 21.74; 95% CI, 20.39–23.18) in the case of TIN, followed by cytotoxic therapies (ROR, 2.60; 95% CI, 2.40–2.82), and targeted therapies (ROR, 1.54; 95% CI, 1.40–1.69).

Conclusion

AKI and TIN were observed significantly after administering anticancer drugs. It is crucial to note that renal adverse reactions were more prominent with immunotherapy, which is increasingly used, compared to other types of anticancer drugs.