Proteinuria Following Administration of Immune Check Point Inhibitor: a Case-control Observational Study

Overview

Journal BMC Nephrol

Publisher Biomed Central

Specialty Nephrology

Date 2024 Nov 28

PMID 39604883

Authors

Jianan Su

Zhuofei Bi

Pengwei Chen

Ziqing Gao

Qiongqiong Yang

Min Feng

Affiliations

Soon will be listed here.

Abstract

Purpose: Proteinuria during treatment of immune checkpoint inhibitors (ICIs) was another renal adverse event besides from acute kidney injury. We aim to investigate the incidence and associated factors of proteinuria associated with ICIs.

Method: A case-control observational study about ICIs-treated cancer patients was conducted. Clinical and laboratory data at the baseline and during the follow-up was collected. Patients developed proteinuria during ICIs-treatment were classified to the proteinuria group.

Results: Between March 2019 and August 2022, 440 patients were included in the study. Forty-eight patients (10.9%) developed proteinuria after ICIs-treatment. The occurrence of acute kidney injury between the proteinuria group and the control showed no difference[1(2.1%) vs. 9(2.3%), p = 1.000]. By multivariable logistic analysis, accumulative cycle of ICIs-administration (OR 1.079, 95% CI 1.033 to 1.127, p = 0.001) and comorbidity of liver cirrhosis (OR 2.198, 95% CI 1.082 to 4.468, p = 0.030) were associated with occurrence of proteinuria after ICIs-treatment independently.

Conclusions: Proteinuria could develop during the course of ICIs-therapy. Urinalysis should be monitored, especially for patients received multi-cycle of ICIs-administration and comorbid with liver cirrhosis.

References

Stein C, Burtey S, Mancini J, Pelletier M, Sallee M, Brunet P . Acute kidney injury in patients treated with anti-programmed death receptor-1 for advanced melanoma: a real-life study in a single-centre cohort. Nephrol Dial Transplant. 2020; 36(9):1664-1674. DOI: 10.1093/ndt/gfaa137. View

Kitchlu A, Fingrut W, Avila-Casado C, Chan C, Crump M, Hogg D . Nephrotic Syndrome With Cancer Immunotherapies: A Report of 2 Cases. Am J Kidney Dis. 2017; 70(4):581-585. DOI: 10.1053/j.ajkd.2017.04.026. View

Daanen R, Maas R, Koornstra R, Steenbergen E, Van Herpen C, Willemsen A . Nivolumab-associated Nephrotic Syndrome in a Patient With Renal Cell Carcinoma: A Case Report. J Immunother. 2017; 40(9):345-348. DOI: 10.1097/CJI.0000000000000189. View

Asemota U, Gulati A, Kumar K, Janga K . Nivolumab-Induced Crescentic Immunoglobulin A Nephropathy With Henoch-Schonlein Purpura Features in a Patient Diagnosed With Hepatocellular Carcinoma. Cureus. 2021; 13(10):e19110. PMC: 8627579. DOI: 10.7759/cureus.19110. View

Tanabe K, Kanzaki H, Wada T, Nakashima Y, Sugiyama H, Okada H . Nivolumab-induced IgA nephropathy in a patient with advanced gastric cancer: A case report. Medicine (Baltimore). 2020; 99(21):e20464. PMC: 7249867. DOI: 10.1097/MD.0000000000020464. View

Ronsin C, Braud P, Kandel-Aznar C, Dujardin A, Petit C, Larmet D . Clinical Presentation, Pathological Spectrum, and Outcomes of Alcoholic Cirrhosis-Related Immunoglobulin A Nephropathy. Kidney Int Rep. 2024; 9(5):1369-1378. PMC: 11069013. DOI: 10.1016/j.ekir.2024.02.1397. View

Lin L, Jenq C, Liu C, Huang C, Fan P, Chang C . Proteinuria can predict short-term prognosis in critically ill cirrhotic patients. J Clin Gastroenterol. 2014; 48(4):377-82. DOI: 10.1097/MCG.0000000000000060. View

Noble J, Jouve T, Malvezzi P, Rostaing L . Renal complications of liver diseases. Expert Rev Gastroenterol Hepatol. 2018; 12(11):1135-1142. DOI: 10.1080/17474124.2018.1530984. View

Kitchlu A, Jhaveri K, Wadhwani S, Deshpande P, Harel Z, Kishibe T . A Systematic Review of Immune Checkpoint Inhibitor-Associated Glomerular Disease. Kidney Int Rep. 2021; 6(1):66-77. PMC: 7783581. DOI: 10.1016/j.ekir.2020.10.002. View

10.

Kim D, Jeon H, Kim S, Lee W, Kim H, Rhee H . Pembrolizumab-induced focal segmental glomerulosclerosis: A case report. Medicine (Baltimore). 2021; 100(43):e27546. PMC: 8556051. DOI: 10.1097/MD.0000000000027546. View

11.

Cholongitas E, Goulis I, Ioannidou M, Soulaidopoulos S, Chalevas P, Akriviadis E . Urine albumin-to-creatinine ratio is associated with the severity of liver disease, renal function and survival in patients with decompensated cirrhosis. Hepatol Int. 2016; 11(3):306-314. DOI: 10.1007/s12072-016-9759-9. View

12.

Xu L, Zhao H, Yu X, Wang J, Zheng X, Jiang L . Clinicopathological Features of Kidney Injury Related to Immune Checkpoint Inhibitors: A Systematic Review. J Clin Med. 2023; 12(4). PMC: 9964206. DOI: 10.3390/jcm12041349. View

13.

Kishi S, Minato M, Saijo A, Murakami N, Tamaki M, Matsuura M . IgA Nephropathy after Nivolumab Therapy for Postoperative Recurrence of Lung Squamous Cell Carcinoma. Intern Med. 2017; 57(9):1259-1263. PMC: 5980806. DOI: 10.2169/internalmedicine.9814-17. View

14.

Ratanasrimetha P, Reddy V, Kala J, Tchakarov A, Glass W, Msaouel P . Case Report: Successful treatment of late-onset immune checkpoint inhibitor-associated membranous nephropathy in a patient with advanced renal cell carcinoma. Front Immunol. 2022; 13:898811. PMC: 9366044. DOI: 10.3389/fimmu.2022.898811. View

15.

Kawataki M, Watanabe K, Yokoyama T, Ishida T . IgA vasculitis as an immune-related adverse event of durvalumab: A case report. Respir Investig. 2023; 61(2):205-209. DOI: 10.1016/j.resinv.2023.01.005. View

16.

Webster A, Nagler E, Morton R, Masson P . Chronic Kidney Disease. Lancet. 2016; 389(10075):1238-1252. DOI: 10.1016/S0140-6736(16)32064-5. View

17.

Ning K, Wu Z, Zou X, Liu H, Wu Y, Xiong L . Immune checkpoint inhibitors further aggravate proteinuria in patients with metastatic renal cell carcinoma after long-term targeted therapy. Transl Androl Urol. 2022; 11(3):386-396. PMC: 8984970. DOI: 10.21037/tau-21-1015. View