Immune checkpoint inhibitors-associated acute kidney injury: a systematic review and meta-analysis of incidence, kidney recovery, and recurrent risk
A 2025 meta-analysis of 16 studies (10,726 patients) found immune checkpoint inhibitor-associated AKI in about 1.4% over one year, that corticosteroids improved kidney recovery, and that roughly 1 in 6 patients had recurrent AKI on rechallenge.
Background
Immune checkpoint inhibitors are widely used in oncology but can cause AKI. Reported incidence varies, and the value of corticosteroids and the safety of rechallenge after an AKI episode remain uncertain.
Study design
Systematic review and meta-analysis searching PubMed, Embase, and the Cochrane Library through May 2024, using a random-effects model to pool incidence, kidney recovery after steroids, and recurrent AKI on rechallenge.
Key findings
Sixteen studies (10,726 participants): pooled one-year incidence 1.4% (95% CI 1.0-2.1), or 4.3 per 100 patient-years; steroid therapy improved recovery (OR 1.82, 1.17-2.83); combining IV and oral steroids gave no added benefit (OR 0.93); recurrent AKI occurred in 18.0% after rechallenge.
Clinical implications
The findings support corticosteroids for ICI-AKI and underscore the need for close kidney-function monitoring when clinicians choose to rechallenge patients who have had a prior episode.
Category
Research
Source
Cancer Immunology, Immunotherapy
More from ASNRT News
Browse the latest news, society announcements, KDIGO guideline updates, and AJNT issue releases on the ASNRT newsroom.