Korean J Intern Med.  2018 Jul;33(4):790-797. 10.3904/kjim.2016.263.

Chronic kidney disease in the BCR-ABL1-negative myeloproliferative neoplasm: a single-center retrospective study

• Baek SW
• Moon JY
• Ryu H
• Choi YS
• Song IC
• Lee HJ
• Yun HJ
• Kim S
• Jo DY

• KMID: 2416006
• DOI: http://doi.org/10.3904/kjim.2016.263

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.

Keyword

BCR-ABL1-negative myeloproliferative neoplasm; Renal insufficiency, chronic; Cytoreductive therapy; Chronic inflammation

MeSH Terms

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*
Hydroxyurea
L-Lactate Dehydrogenase