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

• Published in: The Korean journal of internal medicine Vol. 33; no. 4; pp. 790 - 797
• Main Authors: Seung-woo Baek, Ji Young Moon, Hyewon Ryu, Yoon-seok Choi, Ik-chan Song, Hyo-jin Lee, Hwan-jung Yun, Samyoung Kim, Deog-yeon Jo
• Format: Journal Article
• Language: Korean
• Published: 대한내과학회 31.07.2018
• Subjects: BCR-ABL1-negative myeloproliferative neoplasm; chronic; Chronic inflammation; Cytoreductive therapy; Renal insufficiency
• ISSN: 1226-3303

Background/Aims: Renal complications related to BCR-ABL1-negative myelopro-liferative 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 ㎡) 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 = 0.02 in PV; and 1.55; 95% CI, 0.56 to 2.54; p = 0.02 in treatment with hydroxyurea). In total, 17 patients (20.5%) showed rapid loss of eGFR (< -3 mL/min/1.73 ㎡ per 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 × 10 9 /L) and high monocyte (> 0.7 × 10 9 /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.