Nephrotoxicity of immune checkpoint inhibitor combination therapy in patients with advanced renal cell carcinoma: a meta-analysis.

PURPOSE: Few data are available regarding the nephrotoxicity of immune checkpoint inhibitor (ICI) combination therapy in advanced renal cell carcinoma (RCC). This study aimed to investigate the nephrotoxicity of ICI-based combination therapy versus standard of care sunitinib in patients with advanced RCC. METHODS: We searched Embase/PubMed/Cochrane Library for relevant randomized controlled trials (RCTs). Treatment-related nephrotoxicities including increase of creatinine and proteinuria were analyzed by Review Manager 5.4 software. RESULTS: Seven RCTs involving 5239 patients were included. The analysis showed that ICI combination therapy had similar risks of any grade (RR = 1.03, 95% CI: 0.77-1.37, P = 0.87) and grade 3-5 (RR = 1.48, 95% CI: 0.19-11.66, P = 0.71) increased creatinine compared with sunitinib monotherapy. However, ICI combination therapy was associated with significantly higher risks of any grade (RR = 2.33, 95% CI: 1.54-3.51, P < 0.0001) and grade 3-5 proteinuria (RR = 2.25, 95% CI: 1.21-4.17, P = 0.01). CONCLUSIONS: This meta-analysis suggests that ICI combination therapy shows more nephrotoxicity of proteinuria than sunitinib in advanced RCC, which deserves a high attention in the clinic.

[Adsorption kinetics of phosphate from aqueous solutions onto modified corn residue].

The adsorption kinetics of phosphate from aqueous solutions onto modified corn residue was studied in a hatch reactor. The influence of initial pH, concentration and temperature to adsorption effect were investigated. In addition, the kinetic data were fitted by pseudo-first-order equation, pseudo-second-order equation, modified pseudo-first-order equation and intra-particle diffusion model, and the respective characteristic rate constants were presented. The results showed that the adsorption data fitted Freundlich isotherm model, and the maximum adsorption capacity of phosphate would decrease with the temperature increasing. Furthermore, the adsorption process could reached equilibrium in 30 minutes, and the pseudo-second-order equation and intra-particle diffusion model generated the best agreement with the experimental data for the adsorption systems. The intra-particle diffusion was the main rate-controlling step. With increasing initial concentration, the rate constant of pseudo-second-order equation decreases and that of intra-particle diffusion model increases. The adsorption kinetic analyses could be of a great practical value for the technological applications of phosphate removal from aqueous solutions.