Incidence and Clinical Features of Immune-Related Acute Kidney Injury in Patients Receiving Programmed Cell Death Ligand-1 Inhibitors.
Incidence and Clinical Features of Immune-Related Acute Kidney Injury in Patients Receiving Programmed Cell Death Ligand-1 Inhibitors.
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DOI：
10.1016/j.ekir.2020.07.011
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发表时间：
2020-10
影响因子：
6
通讯作者：
Sise ME
中科院分区：
文献类型：
--
作者：
Seethapathy H;Zhao S;Strohbehn IA;Lee M;Chute DF;Bates H;Molina GE;Zubiri L;Gupta S;Motwani S;Leaf DE;Sullivan RJ;Rahma O;Blumenthal KG;Villani AC;Reynolds KL;Sise ME
程序性细胞死亡受体配体1(PD-L1)抑制剂是一类免疫检查点抑制剂，其副作用可能不同于其他类型的免疫检查点抑制剂，如针对细胞毒性T淋巴细胞−相关蛋白4(CTLA-4)和程序性细胞死亡1受体(PD-1)的免疫检查点抑制剂。作为最近批准的一类检查点抑制剂，目前还没有研究调查接受PD-L1抑制剂的患者发生急性肾损伤(AKI)的频率、病因和预测因素。这是一项对2017至2018年间在我们的医疗系统中接受PD-L1抑制剂治疗的患者进行的回顾性队列研究。AKI的定义是，≥的血清肌酐比基线上升了1.5倍。所有持续AKI(持续48小时)的病因和临床病程通过审查电子健康记录来确定。最终分析包括599名患者。在ICI开始后的12个月内，104名患者(17%)经历了AKI，36名患者(6%)经历了持续性AKI；然而，只有5名患者(1%)经历了疑似PD-L1相关的AKI。PD-L1相关的AKI在开始治疗后的中位数为99天。所有患者同时接受另一种已知的引起急性间质性肾炎的药物(质子泵抑制剂、非类固醇抗炎药或抗生素)，在疑似PDL1相关AKI时。虽然AKI在接受PD-L1治疗的患者中很常见，但疑似PD-L1相关AKI的发生率很低(1%)，与其他类型的ICIS相比可能不太常见。这一队列进一步证实了其他与急性间质性肾炎相关的药物可能参与了ICI相关AKI的发病机制。
Programmed cell death receptor ligand 1 (PD-L1) inhibitors are immune checkpoint inhibitors (ICIs) with a side effect profile that may differ from other classes of ICIs such as those directed against cytotoxic T-lymphocyte−associated protein 4 (CTLA-4) and programmed cell death 1 receptor (PD-1). Being the more recently approved class of checkpoint inhibitors, there are no studies investigating the frequency, etiology and predictors of acute kidney injury (AKI) in patients receiving PD-L1 inhibitors. This was a retrospective cohort study of patients who received PD-L1 inhibitors during 2017 to 2018 in our healthcare system. AKI was defined by a ≥1.5-fold rise in serum creatinine from baseline. The etiology of all cases of sustained AKI (lasting >48 hours) and clinical course were determined by review of electronic health records. The final analysis included 599 patients. Within 12 months of ICI initiation, 104 patients (17%) experienced AKI, and 36 (6%) experienced sustained AKI; however, only 5 (<1%) experienced suspected PD-L1–related AKI. The PD-L1–related AKI occurred a median of 99 days after starting therapy. All patients concurrently received another medication known to cause acute interstitial nephritis (proton pump inhibitors, nonsteroidal anti-inflammatory drugs, or antibiotics) at the time of the suspected PDL1-related AKI. Although AKI is common in patients receiving PD-L1 therapy, the incidence of suspected PD-L1–related AKI is low (<1%) and may be less common when compared to other classes of ICIs. This cohort provides further validation that other drugs associated with acute interstitial nephritis may be involved in the pathogenesis of ICI-related AKI.
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DOI：
10.1084/jem.20130790
发表时间：
2014-05-05
期刊：
The Journal of experimental medicine
影响因子：
--
作者：
Xiao Y;Yu S;Zhu B;Bedoret D;Bu X;Francisco LM;Hua P;Duke-Cohan JS;Umetsu DT;Sharpe AH;DeKruyff RH;Freeman GJ
通讯作者：
Freeman GJ
影响因子：
19.6
作者：
Cortazar FB;Marrone KA;Troxell ML;Ralto KM;Hoenig MP;Brahmer JR;Le DT;Lipson EJ;Glezerman IG;Wolchok J;Cornell LD;Feldman P;Stokes MB;Zapata SA;Hodi FS;Ott PA;Yamashita M;Leaf DE
通讯作者：
Leaf DE
影响因子：
13.2
作者：
Shirali, Anushree C.;Perazella, Mark A.;Gettinger, Scott
通讯作者：
Gettinger, Scott
影响因子：
10.9
作者：
Mamlouk, Omar;Selamet, Umut;Abudayyeh, Ala
通讯作者：
Abudayyeh, Ala
影响因子：
6.2
作者：
Faje, Alexander T.;Lawrence, Donald;Sullivan, Ryan J.
通讯作者：
Sullivan, Ryan J.