Acute Kidney Injury Following Chimeric Antigen Receptor T-Cell Therapy: A Retrospective Cohort Analysis
7 affiliations
- 1Medical Intensive Care Unit, Montpellier University Hospital, 34090 Montpellier, France
- 2Department of Biological Hematology, Montpellier University Hospital, 34090 Montpellier, France
- 3Institute of Human Genetics, Unité Mixte de Recherche, Centre National de la Recherche Scientifique, University of Montpellier, 34396 Montpellier, France
- 4Department of Infectious and Tropical Diseases, Montpellier University Hospital, 34295 Montpellier, France
- 5TransVIHMI INSERM U1175 French National Research Institute for Sustainable Development (IRD) U233, University of Montpellier, 34394 Montpellier, France
- 6Clinical Hematology, Montpellier University Hospital, 34090 Montpellier, France
- 7PhyMedExp, School of Medicine, Inserm—French Institute of Health and Medical Research—CNRS (French National Centre for Scientific Research), University of Montpellier, 34295 Montpellier, France
Abstract
Background: Chimeric antigen receptor T-cell (CAR-T) therapy is associated with numerous adverse effects, among which acute kidney injury (AKI) remains poorly characterized. This study aimed to determine the incidence and risk factors of AKI following CAR-T therapy. Methods: This retrospective study was conducted among adult patients who received CAR-T cell therapy at an university hospital between April 2019 and December 2023. The incidence and risk factors for AKI, as well as its impact on overall survival and progression-free survival, were analyzed using univariate and multivariate analyses. Results: A total of 220 patients were included (mean age 63 ± 12 years), mostly treated for B-cell lymphomas. Pre-existing chronic kidney disease (CKD) was present in 26% of patients, and 24% had been admitted to the intensive care unit. The cumulative incidence of AKI was 20.5% (n = 45), occurring early after CAR-T infusion (4 days). Among AKI cases, 22% were KDIGO stage 3, and 15.6% required renal replacement therapy. In multivariate analysis, pre-existing CKD was strongly associated with AKI occurrence (adjusted OR 8.9), as was exposure to ACEI and ARBs with nephrotoxic agents (adjusted OR 2.7). Severity of cytokine release syndrome, and CAR-T–associated encephalopathy were associated with AKI in univariate analysis. Severe AKI was associated with reduced progression-free survival. Conclusions: Acute kidney injury commonly occurs following CAR-T cell therapy, and its occurrence was closely linked to pre-existing renal comorbidities and cumulative exposure to nephrotoxic agents and ACEI and ARBS. The severity of AKI was associated with reduced overall survival and progression-free survival.
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BibTeX
@article{delneste2026acute,
title = {{Acute Kidney Injury Following Chimeric Antigen Receptor T-Cell Therapy: A Retrospective Cohort Analysis}},
author = {Luc Delneste and Eddine Bendiab and Laura Platon and Caroline Bret and Charlotte Boullé and Nacim Benchabane and Jeremy Contier and Charles Herbaux and Patrice Ceballos and Kada Klouche},
journal = {Journal of Clinical Medicine},
year = {2026},
month = oct,
doi = {10.3390/jcm15218287},
url = {https://www.mdpi.com/2077-0383/15/21/8287},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Acute Kidney Injury Following Chimeric Antigen Receptor T-Cell Therapy: A Retrospective Cohort Analysis
AU - Luc Delneste
AU - Eddine Bendiab
AU - Laura Platon
AU - Caroline Bret
AU - Charlotte Boullé
AU - Nacim Benchabane
AU - Jeremy Contier
AU - Charles Herbaux
AU - Patrice Ceballos
AU - Kada Klouche
PY - 2026
DA - 2026/10/24
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15218287
UR - https://www.mdpi.com/2077-0383/15/21/8287
AB - Background: Chimeric antigen receptor T-cell (CAR-T) therapy is associated with numerous adverse effects, among which acute kidney injury (AKI) remains poorly characterized. This study aimed to determine the incidence and risk factors of AKI following CAR-T therapy. Methods: This retrospective study was conducted among adult patients who received CAR-T cell therapy at an university hospital between April 2019 and December 2023. The incidence and risk factors for AKI, as well as its impact on overall survival and progression-free survival, were analyzed using univariate and multivariate analyses. Results: A total of 220 patients were included (mean age 63 ± 12 years), mostly treated for B-cell lymphomas. Pre-existing chronic kidney disease (CKD) was present in 26% of patients, and 24% had been admitted to the intensive care unit. The cumulative incidence of AKI was 20.5% (n = 45), occurring early after CAR-T infusion (4 days). Among AKI cases, 22% were KDIGO stage 3, and 15.6% required renal replacement therapy. In multivariate analysis, pre-existing CKD was strongly associated with AKI occurrence (adjusted OR 8.9), as was exposure to ACEI and ARBs with nephrotoxic agents (adjusted OR 2.7). Severity of cytokine release syndrome, and CAR-T–associated encephalopathy were associated with AKI in univariate analysis. Severe AKI was associated with reduced progression-free survival. Conclusions: Acute kidney injury commonly occurs following CAR-T cell therapy, and its occurrence was closely linked to pre-existing renal comorbidities and cumulative exposure to nephrotoxic agents and ACEI and ARBS. The severity of AKI was associated with reduced overall survival and progression-free survival.
SN - 2077-0383
ER -