cliot (version 1.0.0)

irae_nephritis_grading: irAE Grading for Nephritis (Renal Toxicities)

Description

Calculates the CTCAE severity grade for immune-mediated nephritis associated with immune checkpoint inhibitor (ICPi) therapy. Grading is determined by the elevation of serum creatinine relative to the Upper Limit of Normal (ULN) or the patient's baseline creatinine.

Usage

irae_nephritis_grading(creatinine_level, creatinine_uln,
                       baseline_creatinine = NULL, life_threatening = 0)

Value

A list containing:

CTCAE_Grade

The calculated adverse event grade (0-4).

Definition

Clinical description of the grade criteria met.

Management_Recommendation

Guidance on ICPi continuation and immunosuppressive therapy based on ASCO guidelines.

Arguments

creatinine_level

Numeric. Current serum creatinine level in mg/dL.

creatinine_uln

Numeric. The laboratory's Upper Limit of Normal for creatinine.

baseline_creatinine

Numeric (Optional). The patient's pre-treatment baseline creatinine level. Used for grading (e.g., >1.5x baseline).

life_threatening

Numeric (0 or 1). Are there life-threatening consequences (e.g., dialysis indicated)? (1 = Yes).

References

Brahmer JR, Lacchetti C, Schneider BJ, et al. Management of Immune-Related Adverse Events in Patients Treated With Immune Checkpoint Inhibitor Therapy: American Society of Clinical Oncology Clinical Practice Guideline. J Clin Oncol. 2018;36(17):1714-1768. doi:10.1200/JCO.2017.77.6385

Examples

# Example 1: Grade 2 Nephritis (Based on ULN)
# Cr 2.0 (ULN 1.2 -> ratio 1.66)
irae_nephritis_grading(2.0, 1.2)

# Example 2: Grade 3 Nephritis (Based on Baseline)
# Cr 3.5 (Baseline 1.0 -> ratio 3.5)
irae_nephritis_grading(3.5, 1.2, baseline_creatinine = 1.0)