Table 2.
Clinical characteristics, by AKI cause
| Variable | AKI-ICI (N = 14) | AKI-Other (N = 10) | Total (N = 24) | P-value |
|---|---|---|---|---|
| HTN, n (%) | 9 (64.3%) | 5 (50.0%) | 14 (58.3%) | 0.48 |
| DM, n (%) | 4 (28.6%) | 2 (20.0%) | 6 (25.0%) | >0.99 |
| CKD, n (%) | 4 (28.6%) | 4 (40.0%) | 8 (33.3%) | 0.67 |
| COPD, n (%) | 4 (28.6%) | 1 (10.0%) | 5 (20.8%) | 0.36 |
| History of autoimmune disease, n (%) | ||||
| T1 DM | 0 (0.0%) | 1 (10.0%) | 1 (4.2%) | 0.42 |
| Hashimoto’s thyroiditis | 0 (0.0%) | 1 (10.0%) | 1 (4.2%) | 0.42 |
| IBD | 0 (0.0%) | 1 (10.0%) | 1 (4.2%) | 0.42 |
| Malignancy treated with ICI, n (%) | 0.71 | |||
| Missing | 2 (14.3%) | 1 (10.0%) | 3 (12.5%) | |
| Melanoma | 6 (42.9%) | 2 (20.0%) | 8 (33.3%) | |
| Lung adenocarcinoma | 1 (7.1%) | 0 (0.0%) | 1 (4.2%) | |
| Lung squamous cell | 2 (14.3%) | 3 (30.0%) | 5 (20.8%) | |
| Renal cell | 0 (0.0%) | 1 (10.0%) | 1 (4.2%) | |
| Bladder/Urothelial | 3 (21.4%) | 3 (30.0%) | 6 (25.0%) | |
| ICI’s received within 8 wks before first AKI episode, n (%) | ||||
| Ipilimumab (CTLA-4) | 2 (14.3%) | 1 (10.0%) | 3 (12.5%) | >0.99 |
| Tremelimumab (CTLA-4) | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | - |
| Nivolumab (PD-1) | 2 (14.3%) | 4 (40.0%) | 6 (25.0%) | 0.19 |
| Pembrolizumab (PD-1) | 9 (64.3%) | 4 (40.0%) | 13 (54.2%) | 0.41 |
| Atezolizumab (PD-L1) | 2 (14.3%) | 1 (10.0%) | 3 (12.5%) | >0.99 |
| Avelumab (PD-L1) | 0 (0.0%) | 1 (10.0%) | 1 (4.2%) | 0.42 |
| Durvalumab (PD-L1) | 1 (7.1%) | 0 (0.0%) | 1 (4.2%) | >0.99 |
| Other | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | - |
| Cemiplimab (PD-1) | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | - |
| ICI’s ever received before first AKI episode, n (%) | ||||
| Ipilimumab (CTLA-4) | 2 (14.3%) | 3 (30.0%) | 5 (20.8%) | 0.62 |
| Tremelimumab (CTLA-4) | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | - |
| Nivolumab (PD-1) | 2 (14.3%) | 4 (40.0%) | 6 (25.0%) | 0.19 |
| Pembrolizumab (PD-1) | 10 (71.4%) | 4 (40.0%) | 14 (58.3%) | 0.21 |
| Atezolizumab (PD-L1) | 2 (14.3%) | 1 (10.0%) | 3 (12.5%) | >0.99 |
| Avelumab (PD-L1) | 0 (0.0%) | 1 (10.0%) | 1 (4.2%) | 0.42 |
| Durvalumab (PD-L1) | 1 (7.1%) | 0 (0.0%) | 1 (4.2%) | >0.99 |
| Other | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | - |
| Cemiplimab (PD-1) | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | - |
| Any TIN drugs, n (%) | 8 (57.1%) | 1 (10.0%) | 9 (37.5%) | 0.019a |
| Antibiotics | 2 (14.3%) | 0 (0.0%) | 2 (8.3%) | 0.49 |
| NSAIDS | 2 (14.3%) | 0 (0.0%) | 2 (8.3%) | 0.49 |
| Proton pump inhibitors | 5 (35.7%) | 1 (10.0%) | 6 (25.0%) | 0.34 |
| Cisplatin, n(%) | 3 (21.4%) | 1 (10.0%) | 4 (16.7%) | 0.62 |
| TKI, n(%) | 1 (7.1%) | 3 (30.0%) | 4 (16.7%) | 0.27 |
| IRAE before AKI, n(%) | 6 (42.9%) | 5 (50.0%) | 11 (45.8%) | >0.99 |
| Rash | 2 (14.3%) | 1 (10.0%) | 3 (12.5%) | >0.99 |
| Colitis | 1 (7.1%) | 0 (0.0%) | 1 (4.2%) | >0.99 |
| Hepatitis | 1 (7.1%) | 0 (0.0%) | 1 (4.2%) | >0.99 |
| Pneumonitis | 1 (7.1%) | 1 (10.0%) | 2 (8.3%) | >0.99 |
| Thyroid disease | 1 (7.1%) | 2 (20.0%) | 3 (12.5%) | 0.55 |
| Hypophysitis | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | - |
| Primary adrenal insufficiency | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | - |
| Type 1 DM | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | - |
| Myocarditis | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | - |
| Other | 4 (28.6%) | 2 (20.0%) | 6 (25.0%) | >0.99 |
| IRAE at time of AKI, n(%) | 7 (50.0%) | 2 (20.0%) | 9 (37.5%) | 0.21 |
| Rash | 3 (21.4%) | 0 (0.0%) | 3 (12.5%) | 0.24 |
| Colitis | 1 (7.1%) | 0 (0.0%) | 1 (4.2%) | >0.99 |
| Hepatitis | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | - |
| Pneumonitis | 1 (7.1%) | 1 (10.0%) | 2 (8.3%) | >0.99 |
| Thyroid disease | 1 (7.1%) | 0 (0.0%) | 1 (4.2%) | >0.99 |
| Hypophysitis | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | - |
| Primary adrenal insufficiency | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | - |
| Type 1 DM | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | - |
| Myocarditis | 1 (7.1%) | 0 (0.0%) | 1 (4.2%) | >0.99 |
| Other | 1 (7.1%) | 1 (10.0%) | 2 (8.3%) | >0.99 |
| Renal recovery, n (%) | 7 (50.0%) | 1 (10.0%) | 8 (33.3%) | 0.079 |
| CRP (mg/l) at time of AKI, median (IQR) | 14.3 (5.0, 31.3) | 5.8 (3.0, 8.2) | 7.5 (4.1, 27.6) | 0.28 |
| uRBP/Cr at time of AKI, median (IQR) | 2208 (918, 16,067) | 1530 (86, 26,735) | 1783 (673, 20,588) | 0.83 |
| AKI stage, n (%) | 0.25 | |||
| 1 | 9 (64.3%) | 6 (60.0%) | 15 (62.5%) | |
| 2 | 4 (28.6%) | 1 (10.0%) | 5 (20.8%) | |
| 3 | 1 (7.1%) | 3 (30.0%) | 4 (16.7%) |
AKI, acute kidney injury; CKD, chronic kidney disease; COPD, chronic obstructive pulmonary disease; Cr, creatinine; CRP, C-reactive protein; CTLA-4, cytotoxic T lymphocyte–associated antigen 4; DM, diabetes mellitus; HTN, hypertension; IBD, inflammatory bowel disease; ICI, immune checkpoint inhibitors; IQR, interquartile range; NSADS, nonsteroidal anti-inflammatory drugs; PD-1, programmed cell death 1; PD-L1, programmed death ligand 1; TIN, tubulo-interstitial nephritis; TKI, tyrosine kinase inhibitor; uRBP/Cr, urine retinol binding protein-to-creatinine ratio.
P-values in bold denote statistical significance at the 0.05 α-level.Unless otherwise indicated, timing is at initiation of ICI therapy.P-values are derived from the equal variance t-test for normally distributed variables, the Wilcoxon rank sum test for non-normally distributed variables, the χ2 test for categorical variables where the expected call counts were ≥5, and the Fisher exact test for categorical variables with an expected cell count of <5. P-values in bold denote statistical significance at the 0.05 α-level.