Clinicopathological Features of Kidney Injury Related to Immune Checkpoint Inhibitors: A Systematic Review

被引：9

作者：

Xu, Ling-Yi ^{[1
,2
,3
,4
,5
]}

Zhao, Hai-Ya ^{[1
,2
,3
,4
,5
,6
]}

Yu, Xiao-Juan ^{[1
,2
,3
,4
,5
]}

Wang, Jin-Wei ^{[1
,2
,3
,4
,5
]}

Zheng, Xi-Zi ^{[1
,2
,3
,4
,5
]}

Jiang, Lei ^{[1
,2
,3
,4
,5
]}

Wang, Su-Xia ^{[1
,2
,3
,4
,5
,7
]}

Liu, Gang ^{[1
,2
,3
,4
,5
]}

Yang, Li ^{[1
,2
,3
,4
,5
]}

机构：

[1] Peking Univ, Peking Univ Hosp 1, Inst Nephrol, Dept Med,Renal Div, Beijing 100034, Peoples R China

[2] Peking Univ First Hosp, Inst Nephrol, Renal Pathol Ctr, Beijing 100034, Peoples R China

[3] Minist Hlth China, Key Lab Renal Dis, Beijing 100034, Peoples R China

[4] Minist Educ China, Key Lab CKD Prevent & Treatment, Beijing 100034, Peoples R China

[5] Chinese Acad Med Sci, Res Units Diag & Treatment Immune Mediated Kidney, Beijing 100034, Peoples R China

[6] Peking Univ, Hlth Sci Ctr, Year Program 8, Grade 2019, Beijing 100191, Peoples R China

[7] Peking Univ First Hosp, Pathol Ctr, Lab Electron Microscopy, Beijing 100034, Peoples R China

来源：

JOURNAL OF CLINICAL MEDICINE | 2023年 / 12卷 / 04期

基金：

中国国家自然科学基金;

关键词：

acute kidney injury; immune checkpoint inhibitors; immune-related adverse events; pathological features; ACUTE INTERSTITIAL NEPHRITIS; DEATH; INHIBITOR; TUBULOINTERSTITIAL NEPHRITIS; NIVOLUMAB; BLOCKADE; IPILIMUMAB; THERAPY; QUALITY; ANTI;

D O I：

10.3390/jcm12041349

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

(1) Background: Despite increasing recognition of immune checkpoint inhibitors (ICIs) and kidney immune-related adverse events (IRAEs), no large-sample studies have assessed the pathological characteristics and outcomes of biopsy-proven kidney IRAEs. (2) Methods: We comprehensively searched PubMed, Embase, Web of Science, and Cochrane for case reports, case series, and cohort studies for patients with biopsy-proven kidney IRAEs. All data were used to describe pathological characteristics and outcomes, and individual-level data from case reports and case series were pooled to analyze risk factors associated with different pathologies and prognoses. (3) Results: In total, 384 patients from 127 studies were enrolled. Most patients were treated with PD-1/PD-L1 inhibitors (76%), and 95% presented with acute kidney disease (AKD). Acute tubulointerstitial nephritis/acute interstitial nephritis (ATIN/AIN) was the most common pathologic type (72%). Most patients (89%) received steroid therapy, and 14% (42/292) required RRT. Among AKD patients, 17% (48/287) had no kidney recovery. Analyses of pooled individual-level data from 221 patients revealed that male sex, older age, and proton pump inhibitor (PPI) exposure were associated with ICI-associated ATIN/AIN. Patients with glomerular injury had an increased risk of tumor progression (OR 2.975; 95% CI, 1.176, 7.527; p = 0.021), and ATIN/AIN posed a decreased risk of death (OR 0.164; 95% CI, 0.057, 0.473; p = 0.001). (4) Conclusions: We provide the first systematic review of biopsy-proven ICI-kidney IRAEs of interest to clinicians. Oncologists and nephrologists should consider obtaining a kidney biopsy when clinically indicated.

引用

页数：14