Baseline eGFR predicts inhibitor-induced AKI

A recent study has found three baseline characteristics that can predict sustained acute kidney injury (AKI), and these include estimated glomerular filtration rate (eGFR), loop diuretic, and spironolactone use. For immune checkpoint inhibitor-related AKI, only baseline eGFR is predictive.

This retrospective cohort study included 906 patients who received at least one dose of a checkpoint inhibitor at a rural health system from May 2013 to February 2020. The investigators performed an electronic and manual chart review to determine the incidence of, risk factors for, and renal outcomes and management strategies of checkpoint inhibitor-related AKI.

The impact of patient characteristics on the incidence of sustained AKI and checkpoint inhibitor-induced AKI was examined using multivariable Fine and Gray subdistribution hazard models.

AKI incidence of any duration and due to any cause was 36.1 percent, while sustained AKI incidence was 28.7 percent. In addition, the incidence of checkpoint inhibitor-induced AKI was 2.7 percent.

The only factor that predicted checkpoint inhibitor-related AKI was baseline eGFR <60. Most patients with suspected checkpoint inhibitor-related AKI received corticosteroids, and 62.5 percent achieved complete recovery.

“Ours is the first retrospective cohort study to test whether baseline Eastern Cooperative Oncology Group score and checkpoint inhibitor place in therapy were associated with checkpoint inhibitor-related AKI, and neither of these data points were found to be predictive,” the investigators said.