ToolsCalculators
Immune-Related Adverse Events for Renal Toxicities - Nephritis
CTCAE-based severity grade for acute kidney injury/nephritis from checkpoint inhibitor therapy.
Immune-Related Adverse Events for Renal Toxicities - Nephritis
Baseline (pre-treatment) creatinine
Current creatinine
Dialysis indicated
Complete the fields above to see the result.
When to use
- Grading acute kidney injury/nephritis attributed to immune checkpoint inhibitor therapy once prerenal, obstructive, and other drug-related causes have been excluded.
Formula
CTCAE v5.0 acute-kidney-injury grading applied to ICPi nephritis, based on serum creatinine relative to baseline: Grade 1, increase >0.3 mg/dL or 1.5-2x baseline; Grade 2, 2-3x baseline; Grade 3, >3x baseline or >4.0 mg/dL, hospitalization indicated; Grade 4, life-threatening, dialysis indicated.
Pearls and pitfalls
- Acute interstitial nephritis is the most common histologic pattern on biopsy in ICPi-related nephritis.
- Concomitant nephrotoxic drugs (NSAIDs, proton pump inhibitors, antibiotics) are common confounders and should be reviewed before attributing AKI to the ICPi.