Risk Factors Analysis of AKI in Patients with Primary Non-small Cell Lung Cancer Treated with PD-1/PD-L1 Inhibitor

Abstract

Introduction. To investigate the risk factors of Programmed Cell
Death Protein 1 (PD-1), Programmed Cell Death Ligand 1(PD-L1)
inhibitor associated acute kidney injury (AKI) in patients with
primary non-small cell lung cancer (NSCLC) and construct a
predictive model.
Methods. 120 NSCLC patients were selected as the research subjects
and their clinical data were collected. Patients were divided into
AKI and Non-AKI (N-AKI) group based on the development of AKI.
Exploring the risk factors of PD-1P/D-L1 inhibitor related AKI in
NSCLC patients using multivariate logistic regression analysis and
visualized the logistic regression analysis to obtain a nomogram
model. Meanwhile, evaluate the predictive value of the model.
Results. The results of multivariate analysis showed that the presence
of extrarenal immune related adverse reactions (irAEs) is a risk
factor for PD-1/PD-L1 inhibitor related AKI in NSCLC patients;
At the same time, the risk of developing PD-1/PD-L1 inhibitor
related AKI in NSCLC patients increases with increasing serum
creatinine (SCr) and C-reactive protein (CRP) levels, decreasing
baseline estimated glomerular filtration rate (eGFR) levels (P < .05).
The analysis results of receiver operator characteristic curve (ROC),
calibration curve, and decision curve show that the model has
good discrimination and accuracy, and can achieve a high clinical
benefit rate.
Conclusion. Primary NSCLC patients with extrarenal irAEs, high
levels of SCr and CRP, and low levels of eGFR have a higher
risk of AKI after PD-1/PD-L1 inhibitor treatment. Establishing a
predictive model with high accuracy is more conducive to early
detection of high-risk patients.

DOI: 10.52547/ijkd.7964