已经零星报道了多种免疫检查位点抑制剂（ICIs）相关急性肾损伤（AKI）的风险因素。为了在大规模人群中确定ICIs相关AKI的风险因素，我们进行了系统性回顾和实际的回顾性研究。我们通过检索ClinicalTrials.gov和电子数据库（PubMed，Cochrane Library，Embase）了解了有关ICIs相关AKI风险因素的文献，时间截至2022年1月。我们用95％置信区间的比值比（OR）进行元分析。并使用美国FDA不良事件报告系统（FAERS）数据库中的数据进行分离的回顾性药物监测研究，以使用报告比值比（ROR）进行比例失调分析。共纳入了9个研究（5927例患者）进行元分析。下列因素与ICIs相关AKI的风险增加有关，包括质子泵抑制剂（PPI）（OR = 2.07，95％CI 1.78-2.42），血管紧张素转化酶抑制剂（ACEI）/血管紧张素II受体拮抗剂（ARB）（OR = 1.56，95％CI 1.24-1.95），非甾体类消炎药（NSAID）（OR = 1.29，95％CI 1.01-1.65），利尿剂（OR = 2.00，95％CI 1.38-2.89），糖尿病（OR = 1.28，95％CI 1.04-1.57），泌尿生殖系统癌症（OR = 1.46，95％CI 1.15-1.85），ICIs的联合治疗（OR = 1.93，95％CI 1.25-2.97）和非肾脏免疫相关不良事件（irAEs）（OR = 2.51，95％CI 1.96-3.20）。此外，来自FAERS数据库的分析验证了PPI（ROR = 2.10，95％CI 1.91-2.31），ACEI / ARB（ROR = 3.25，95％CI 2.95-3.57），NSAID（ROR = 3.06，95％CI 2.81-3.32）或利尿剂（ROR = 2.82，95％CI 2.50-3.19）的同时暴露与ICIs治疗患者中的AKI显着相关。同时暴露于PPI，ACEI / ARB，NSAID或利尿剂，糖尿病，泌尿生殖系统癌症，联合治疗和非肾脏irAEs似乎会增加ICIs治疗患者的AKI风险。©2023年作者。

Several risk factors of immune checkpoint inhibitors (ICIs)-associated acute kidney injury (AKI) have been reported sporadically. To identify the risk factors of ICIs-associated AKI in a large-scale population, therefore we conducted a systematic review and a real-world retrospective study.We search literature concerning risk factors of ICIs-associated AKI in ClinicalTrials.gov and electronic databases (PubMed, Cochrane Library, Embase) up to January 2022. Meta-analysis was performed by using odds ratios (ORs) with 95%CIs. In a separate retrospective pharmacovigilance study by extracting data from US FDA Adverse Event Reporting System (FAERS) database, disproportionality was analyzed using the reporting odds ratio (ROR).A total of 9 studies (5927 patients) were included in the meta-analysis. The following factors were associated with increased risk of ICIs-associated AKI, including proton pump inhibitors(PPIs) (OR = 2.07, 95%CI 1.78-2.42), angiotensin-converting enzyme inhibitors (ACEIs)/ angiotensin receptor blockers (ARBs) (OR = 1.56, 95%CI 1.24-1.95), nonsteroidal anti-inflammatory drugs (NSAIDs) (OR = 1.29, 95%CI 1.01-1.65), diuretics (OR = 2.00, 95%CI 1.38-2.89), diabetes mellitus (OR = 1.28, 95%CI 1.04-1.57), genitourinary cancer (OR = 1.46, 95%CI 1.15-1.85), combination therapy of ICIs (OR = 1.93, 95%CI 1.25-2.97) and extrarenal immune-related adverse events(irAEs) (OR = 2.51, 95%CI 1.96-3.20). Furthermore, analysis from FAERS database verified that concurrent exposures of PPIs (ROR = 2.10, 95%CI 1.91-2.31), ACEIs/ARBs (ROR = 3.25, 95%CI 2.95-3.57), NSAIDs (ROR = 3.06, 95%CI 2.81-3.32) or diuretics (ROR = 2.82, 95%CI 2.50-3.19) were observed significant signals associated with AKI in ICIs-treated patients.Concurrent exposures of PPIs, ACEIs/ARBs, NSAIDs or diuretics, diabetes mellitus, genitourinary cancer, combination therapy, and extrarenal irAEs seem to increase the risk of AKI in ICIs-treated patients.© 2023. The Author(s).