NDT – Basic and Clinical Science is an official publication of the European Renal Association-European Dialysis and Transplant Association. NDT publishes Editorials, Reviews and original research. Special Report: working group papers, position statements, guidelines papers (on invitation only), NDT Digest (on invitation only) and (only) online E-letters to the Editor commenting on papers previously published in the journal are also considered. The journal covers the whole territory of nephrology research including experimental work in animal models and molecular biology studies. In the Clinical Science section we consider clinical trials (RCT have a priority in our journal), observational studies at large and original works on health economy as applied to nephrology. We aim to cover the whole spectrum of kidney disease research, from clinical nephrology to haemodialysis and peritoneal dialysis as well as renal transplantation.
Harish Seethapathy, Nifasha Rusibamayila, Donald F. Chute, Meghan Lee, Ian A. Strohbehn, Leyre Zubiri, Alexander T. Faje, Kerry L. Reynolds, Kenar D. Jhaveri, Meghan E. Sise
AbstractBackgroundHyponatremia due to endocrinopathies such as adrenal insufficiency and hypothyroidism has been reported in patients receiving immune checkpoint inhibitors (ICIs). We determined the risk and predictors of hyponatremia and other electrolyte abnormalities in a ‘real-world’ sample of patients receiving ICIs to treat advanced malignancies.MethodsThis was a retrospective observational study of all patients who received ICIs from a single cancer center between 2011 and 2018. Patients were followed for 12 months after initiation of ICIs or until death. Common Terminology for Cancer Adverse Events version 5.0 criteria were used to grade the severity of hyponatremia and other electrolyte abnormalities. The predictors of severe (Grade 3 or 4) hyponatremia were determined using a multivariable logistic regression model. The etiology of Grade 3 or 4 hyponatremia was determined by chart review.ResultsA total of 2458 patients were included. Their average age was 64 years [standard deviation (SD) 13], 58% were male and 90% were white. In the first year after starting ICIs, 62% experienced hyponatremia (sodium <134 mEq/L) and 136 (6%) experienced severe hyponatremia (<124 mEq/L). Severe hyponatremia occurred on average 164 days (SD 100) after drug initiation. Only nine cases of severe hyponatremia were due to endocrinopathies (0.3% overall incidence). Risk factors for severe hyponatremia included ipilimumab (a cytotoxic T lymphocyte antigen-4 inhibitor) use, diuretic use and non-White race. Other severe electrolyte abnormalities were also commonly observed: severe hypokalemia (potassium <3.0 mEq/L) occurred in 6%, severe hyperkalemia (potassium ≥6.1 mEq/L) occurred in 0.6%, severe hypophosphatemia (phosphorus <2 mg/dL) occurred in 17% and severe hypocalcemia (corrected calcium <7.0 mg/dL) occurred in 0.2%.ConclusionsHyponatremia is common in cancer patients receiving ICIs. However, endocrinopathies are an uncommon cause of severe hyponatremia.
Dagan Jenkins, Maria Bitner‐Glindzicz, M.A. Ferguson‐Smith, Jennifer Allison, Rose de Bruyn, Sarah E. Flanagan, Dave Thomas, Rachel Belk, Sally Feather, Coralie Bingham, Jennifer Southgate, Adrian S. Woolf
Zhonggao Xu, Dong‐Ryeol Ryu, Tae‐Hyun Yoo, Dukyoo Jung, Ju-Young Kim, Hyung Jun Kim, Hoon Young Choi, J.-S. Kim, Sharon G. Adler, Rama Natarajan, Dong-In Han, Shin‐Wook Kang