Table 3 Reported risk factors for ICI-AKD

From: The nephrotoxic effects of anti-cancer therapies: consensus report of the 34th Acute Disease Quality Initiative workgroup

Study (date)

Criteria for ICI-AKDa

No. patients with ICI-AKD (%)

No. patients biopsied (%)

No. patients with ATIN on biopsy (%)

Risk factors for ICI-AKD

PPI use

Extrarenal IRAE

Lower baseline eGFR

Combination ICI therapy

Seethapathy et al. (2019)77

SCr ≥1.5× baseline for ≥3 days; expert adjudicated

30 (3)

1 (3)

1 (100)

Risk increased

Not assessedb

Risk not increased

Risk not increased

Cortazar et al. (2020)79

SCr ≥2× baseline or need for KRT

138 (100)

60 (43)

56 (93)

Risk increased

Not assessed

Risk increased

Risk increased

Gupta et al. (2021)7

Expert adjudicated ICI-AKI and either SCr ≥2× baseline or SCr ≥1.5× baseline and ATIN on kidney biopsy, ICI held due to concern for ICI-AKI or treated with glucocorticoids

429 (100)

151 (35)

125 (83)

Risk increased

Risk increased

Risk increased

Risk not increased

Koks et al. (2021)75

SCr ≥1.5× baseline on at least two consecutive checks or need for KRT and absence of alternative cause, and at least one of sterile pyuria, eosinophilia or recent or concomitant non-kidney IRAEc

32 (4.7)d

1 (3)

1 (100)

Risk increased

Not assessed

Risk not increased

Risk not increased

  1. ATIN, acute tubulointerstitial nephritis; eGFR, estimated glomerular filtration rate; ICI-AKD, immune-checkpoint inhibitor-associated acute kidney disease; IRAE, immune-related adverse events; KRT, kidney replacement therapy; PPI, proton pump inhibitor; SCr, serum creatinine. aOnly studies that evaluated independent risk factors for immune-checkpoint inhibitor-associated acute kidney injury (ICI-AKI) and included ≥30 patients with suspected ICI-AKI were included. b26 of 30 (87%) patients with potential ICI-AKD had a concurrent IRAE. cKoks et al. included patients with possible or probable ICI-AKD. The diagnostic criteria provided are for probable ICI-AKD. Possible ICI-AKD was defined as the absence of a clear alternative aetiology. d8 patients had probable ICI-AKD, 23 had possible ICI-AKD and 1 had biopsy-proven ATIN.