Table 1.
Characteristics of reported patients with glomerular disease associated with immune checkpoint inhibitors (N = 45)
| Characteristic | IQR or n (%)a |
|---|---|
| Age, yrs (IQR) | 63 (55.8–72.3) |
| Sex, n (%) | |
| Female | 10 (25.0) |
| Male | 30 (75.0) |
| Primary cancer site, n (%) | |
| Lung cancer | 10 (23.8) |
| Lymphoma | 3 (7.1) |
| Melanoma | 16 (38.1) |
| Renal cell carcinoma | 6 (14.3) |
| Other cancers | 7 (16.7) |
| Immunotherapy, n (%) | |
| CTLA-4 agents | 9 (21.4) |
| PD-1/PD-L1 agents | 34 (81.0) |
| Ipilimumab | 5 (11.9) |
| Nivolumab | 15 (35.7) |
| Pembrolizumab | 15 (35.7) |
| Tremelimumab | 2 (4.8) |
| Combination: ipilimumab plus nivolumab | 4 (9.5) |
| Other | 1 (2.4) |
| Glomerular disease type, n (%) | |
| Amyloid A amyloidosis | 4 (8.9) |
| Anti-GBM | 3 (6.7) |
| C3GN | 5 (11.1) |
| FSGS | 2 (4.4) |
| Immunoglobulin A nephropathy | 4 (8.9) |
| Immune-complex GN | 2 (4.4) |
| Lupus-like nephritis | 1 (2.2) |
| Minimal change disease | 9 (20.0) |
| Membranous nephropathy | 1 (2.2) |
| Pauci-immune GN/renal vasculitis | 12 (26.7) |
| Thrombotic microangiopathy | 2 (4.4) |
| Glomerular disease characteristics | |
| Time from therapy start to glomerular disease, days (IQR) | 93 (43.5–212) |
| Baseline serum creatinine, mg/day (IQR) | 0.95 (0.78–1.20) |
| Peak serum creatinine, mg/day (IQR) | 3.4 (2.25–3.36) |
| RRT requirement during AKI, n (%) | 10 (25) |
| Peak proteinuria, g/day (IQR) | 8.25 (4.33–13.0) |
| Other IRAEs, n (%) | 5 (16.1) |
| Associated tubulointerstitial nephritis, n (%) | 17 (40.5) |
| Treatment characteristics | |
| Immune checkpoint inhibitor discontinuation, n (%) | 37 (88.1) |
| Corticosteroid use, n (%) | 39 (97.5) |
| Corticosteroid taper duration, days (IQR) | 90 (60–120) |
| Immune checkpoint inhibitor rechallenge, n (%) | 4 (8.9) |
| Recurrence of glomerular disease after rechallenge, n (%) | 2 (4.4) |
| Outcomes, n (%) | |
| AKI outcome (n = 36) | |
| Full recovery | 11 (30.6) |
| Partial recovery | 15 (41.7) |
| No recovery (non-ESKD) | 3 (8.3) |
| ESKD | 7 (19.4) |
| Proteinuria outcome (n = 29) | |
| Complete remission | 13 (44.8) |
| Partial remission | 11 (37.9) |
| No remission | 5 (17.2) |
| Cancer outcome (n = 32) | |
| Stable/remission | 16 (50.0) |
| Progression | 5 (15.6) |
| Death | 11 (34.4) |
AKI, acute kidney injury; C3GN, complement 3 glomerulonephritis; CTLA-4, cytotoxic T-lymphocyte antigen 4; ESKD, end-stage kidney disease; FSGS, focal segmental glomerulosclerosis; GBM, glomerular basement membrane; GN, glomerulonephritis; IgA, immunoglobulin A; IQR, interquartile range; IRAEs, immune-related adverse events;
PD-1, programmed cell death 1; PD-L1, programmed cell death ligand 1; RRT, renal replacement therapy.
Data are shown as median (IQR) for continuous variables and n (%).
a
Percentages for each characteristic are calculated as a proportion of the number of patients with data available.