In:
Clinical Kidney Journal, Oxford University Press (OUP), ( 2023-11-28)
Abstract:
It is noted immune checkpoint inhibitors (ICIs) were associated with AKI. However, the occurrence rate of ICIs-related AKI was not been systematically examined. Additionally, exposure to PPI and NSAID were considered as a risk factor for AKI but with inconclusive results in ICIs related AKI. Our aim was to analyze the occurrence rate of all-cause AKI and ICIs-related AKI, to analyze the occurrence rates of severe AKI and dialysis-requiring AKI, to determine whether exposure to PPIs and NSAIDs posed a risk factor for all-cause and ICIs-related AKI. Methods This study population was adult ICI recipients. Systematic review by searching MEDLINE, EMBASE, PubMed through Oct 2023. Prospective trials and observational studies that reported any of the following outcomes: the occurrence rate of all-cause or ICIs-related AKI, the relationship between PPI or NSAID exposure and AKI development, or the mortality rate in the AKI or non-AKI group. Proportional meta-analysis, pairwise meta-analysis was performed. The evidence certainty was assessed using GRADE framework. Results A total of 120 studies comprising 46 417 patients were included. The occurrence rates of all-cause AKI were 7.4% (14.6% from retrospective studies and 1.2% from prospective clinical trials). The occurrence rate of ICIs-related AKI was 3.2%. The use of PPIs was associated with an odds ratio (OR) of 1.92 1.77 (95% CI: 1.43–2.18) for all-cause AKI and an OR of 2.42 (95% CI: 1.96–2.97) for ICI-related AKI. The use of NSAIDs was associated with an OR of 1.77 (95% CI: 1.10–2.83) for all-cause AKI and an OR of 2.57 (95% CI: 1.68–3.93) for ICI-related AKI. Conclusions Our analysis revealed that approximately 1 in 13 adult ICIs recipients may experience all-cause AKI, while 1 in 33 adult ICI recipients may experience ICIs-related AKI. Exposure to PPIs and NSAIDs was associated with an increased odds ratio risk for AKI in current meta-analysis.
Type of Medium:
Online Resource
ISSN:
2048-8505
,
2048-8513
Language:
English
Publisher:
Oxford University Press (OUP)
Publication Date:
2023
detail.hit.zdb_id:
2656786-6
