Abstract: SA-PO1248
Immune Checkpoint Inhibitors in Patients with Cancer and CKD: A Systematic Review and Meta-Analysis
Session Information
- Onconephrology: Epidemiological Trends, Risk Stratification, and Clinical Outcomes
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Onconephrology
- 1600 Onconephrology
Authors
- Silva, Rafaela Pereira, Department of Medicine, Federal University of Maranhão, São Luís, Brazil
- Ferreira, Matheus Hissa Lourenço, Department of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
- Miranda, Rafael Lopes, Department of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
- de Amorim, Davi Ricardo Soares Gama, Department of Medicine, University of Pernambuco, Pernambuco, Brazil
- de Almeida, Vitor Paiva, Federal University of Catalão, Catalão, Brazil
- Alles, Isabela, Department of Medicine, University of Santa Cruz do Sul, Santa Cruz do Sul, Brazil
- Liberata, Livia, Department of Cardiology, Norfolk and Norwich University Hospital, Norwich Medical School, Norwich, United Kingdom
- Duque, Juan, University of Miami Miller School of Medicine, Miami, Florida, United States
Background
Immune checkpoint inhibitors (ICIs) have transformed cancer therapy, yet their efficacy and safety in patients with chronic kidney disease (CKD) remain uncertain. We aimed to evaluate clinical outcomes of ICI therapy in patients with cancer and CKD
Methods
We conducted a systematic review and meta-analysis comparing outcomes of ICI therapy in patients with and without CKD. PubMed, Embase, and the Cochrane Library were systematically searched. Eligible studies included patients with CKD stages 3–5 reporting at least one efficacy or safety outcome; kidney transplant recipients were excluded. Subgroup analyses were performed for advanced CKD. Hazard ratios (HR) and risk ratios (RR) with 95% confidence intervals (CI) were pooled using random-effects models
Results
Fourteen studies (n = 12,589 patients) were included. Patients with CKD had a significantly higher risk of nephritis (RR 2.43; 95% CI 1.11–5.33) compared with those without CKD. No significant differences were observed in acute kidney injury (RR 1.39; 95% CI 0.93–2.08), overall survival (HR 0.97; 95% CI 0.58–1.61), or progression-free survival (HR 1.05; 95% CI 0.76–1.44). The incidence of any-grade irAEs (RR 1.01; 95% CI 0.96–1.07) and grade ≥3 irAEs (RR 1.07; 95% CI 0.92–1.25) was also similar between groups. However, advanced CKD was associated with worse overall survival (HR 1.42; 95% CI 1.14–1.76) and a higher incidence of any-grade irAEs (RR 1.17; 95% CI 1.01–1.34)
Conclusion
These findings suggest that ICIs may be considered in patients with moderate CKD, while advanced CKD identifies a subgroup with a higher risk of any-grade irAEs and worse overall survival, despite preserved tumor response