Incidence and clinical features of immune-related acute kidney injury in patients receiving Programmed Cell Death Ligand-1 Inhibitors

Abstract Background Programmed cell death receptor ligand 1 (PD-L1) inhibitors are immune checkpoint inhibitors (ICIs) whose side effect profile 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. Methods Retrospective cohort study of patients who received PD-L1 inhibitors during 2017- 2018 in our healthcare system. Acute kidney injury (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. Results 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 ( Conclusion Although AKI is common in patients receiving PD-L1 therapy, the incidence of suspected PD-L1-related AKI is low (