Chronic kidney disease in the BCR-ABL1-negative myeloproliferative neoplasm: a single-center retrospective study.
- Author:
Seung Woo BAEK
1
;
Ji Young MOON
;
Hyewon RYU
;
Yoon Seok CHOI
;
Ik Chan SONG
;
Hyo Jin LEE
;
Hwan Jung YUN
;
Samyoung KIM
;
Deog Yeon JO
Author Information
- Publication Type:Original Article
- Keywords: BCR-ABL1-negative myeloproliferative neoplasm; Renal insufficiency, chronic; Cytoreductive therapy; Chronic inflammation
- MeSH: Asian Continental Ancestry Group; Diagnosis; Glomerular Filtration Rate; Humans; Hydroxyurea; Incidence; Kidney; Kidney Diseases; L-Lactate Dehydrogenase; Linear Models; Monocytes; Neutrophils; Polycythemia Vera; Prevalence; Renal Insufficiency, Chronic*; Retrospective Studies*
- From:The Korean Journal of Internal Medicine 2018;33(4):790-797
- CountryRepublic of Korea
- Language:English
- Abstract: 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 (<–3 mL/min/1.73 m2per year). This rapid loss in eGFR was associated with a higher incidence of kidney disease (23.5% vs. 6.1%, p= 0.05) and a higher percentage of patients with high neutrophil (>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.
