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KMID : 0338420180330040790
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The Korean Journal of Internal Medicine
2018 Volume.33 No. 4 p.790 ~ p.797
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Chronic kidney disease in the BCR-ABL1-negative myeloproliferative neoplasm: a single-center retrospective study
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Baek Seung-Woo
Moon Ji-Young
Ryu Hye-Won
Choi Yoon-Seok
Song Ik-Chan
Lee Hyo-Jin
Yun Hwan-Jung
Kim Sa-Myoung
Jo Deog-Yeon
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Abstract
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Background/Aims: Renal complications related to BCR-ABL1-negative myeloproliferative neoplasms (MPNs) have not been examined fully in Asian populations.
Methods: We analyzed estimated glomerular filtration rate (eGFR) and its changes with time retrospectively in patients with BCR-ABL1-negative MPN from 2005 to 2015.
Results: The prevalence of chronic kidney disease (CKD) was 11% (6.6% having stage 3 and 4.4% having stage 4). In a linear regression analysis of eGFR versus time (years), overall, patients showed increased eGFR (mL/min/1.73 m2) by 0.51 (95% confidence interval [CI], ?0.30 to 1.33; p = 0.22). Patients with polycythemia vera (PV), and those treated with hydroxyurea, showed statistically significant increases in eGFR (1.59; 95% CI, 0.28 to 2.90; p = 0.22 in PV; and 1.55; 95% CI, 0.56 to 2.54; p = 0.22 in treatment with hydroxyurea). In total, 17 patients (20.5%) showed rapid loss of eGFR (7.0 × 109 /L) and high monocyte (> 0.7 × 109 /L) counts (76.5% vs. 50%, p=0.05; 52.9% vs. 28.8%, p= 0.06, respectively). More patients had high serum lactate dehydrogenase (> 500 U/L) levels (52.9% vs. 25.8%, p = 0.03) at diagnosis.
Conclusions: CKD is prevalent in patients with BCR-ABL1-negative MPN. Active cytoreductive therapy has the potential to improve kidney function in BCR-ABL1-negative MPN.
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KEYWORD
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BCR-ABL1-negative myeloproliferative neoplasm, Renal insufficiency, chronic, Cytoreductive therapy, Chronic inflammation
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