Assessment of kidney injury during immune-targeted therapy (pembrolizumab + axitinib) in patients with metastatic renal cell carcinoma and solitary kidney; Оценка почечного повреждения на фоне иммунотаргетной терапии (пембролизумаб + акситиниб) у пациентов с метастатическим почечно-клеточным раком с единственной почкой

Aim. To assess the rate and type of kidney injury in the first 28 weeks of pembrolizumab and axitinib therapy after nephrectomy in patients with metastatic renal cell carcinoma and solitary kidney. Materials and methods. The retrospective study included 50 patients who previously underwent nephrectomy due to stage III-IV stage renal cell carcinoma. After nephrectomy prior to the start of antitumor therapy for cancer progression, 84 % of the patients were diagnosed with stage II and higher chronic kidney disease. Results. During antitumor drug treatment, acute kidney injury 14 and 28 weeks after the start of immune-targeted therapy was diagnosed in 4 % and 6 % of patients, respectively. Dynamics of the change in acute kidney injury in 28 weeks were not statistically significant (p = 0.983). Changes in serum creatinine, urea, and glomerular filtration rate were also insignificant. Statistically significant elevation of hemoglobin and hematocrit was observed during the 28 weeks of observation. Hemoglobin level increased from 128.1 g/L before the treatment to its maximal value of 141.7 g/L after the third injection of pembrolizumab (p <0.001). Conclusion. No significant kidney injury was observed during 28 weeks of observation in this single cohort study of patients with metastatic renal cell carcinoma after nephrectomy receiving pembrolizumab and axitinib. © 2025 Elsevier B.V., All rights reserved.