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640 Characterizing severe acute kidney injury in patients treated with immune checkpoint inhibitors

Background Renal immune-related adverse events (irAEs), are relatively rare in patients treated with immune checkpoint inhibitors (ICIs). This retrospective analysis characterizes the etiology of severe acute kidney injury (AKI) in patients treated with ICIs at the University of California, San Diego. Methods The electronic medical record was used to identify all patients with an estimated glomerular filtration rate (eGFR) Results 46 patients who received ICI therapy and subsequently developed an AKI with eGFR Conclusions In our cohort, 6.5% of patients who develop AKI after receiving ICI therapy experienced immune-related nephritis. A further 8.7% of patients experienced other irAEs with AKI, suggesting that the true prevalence of immune-related nephritis is likely underdiagnosed. Notably, 84.8% of patients who develop AKI after ICI therapy have a non-ICI-related etiology, and no patient in our cohort of 46 patients underwent renal biopsy, highlighting the need for blood-based biomarker development for immune-related nephritis. Ethics Approval The study was approved by the University of California San Diego’s Institutional Review Board, approval number 150348.