Kidney Dysfunction Is Associated with Thrombosis and Disease Severity in Myeloproliferative Neoplasms: Implications from the German Study Group for MPN Bioregistry.
Kidney Dysfunction Is Associated with Thrombosis and Disease Severity in Myeloproliferative Neoplasms: Implications from the German Study Group for MPN Bioregistry.
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肾功能障碍与骨髓增生性肿瘤中的血栓形成和疾病严重程度有关：MPN生物学研究组的意义。
DOI：
10.3390/cancers13164086
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发表时间：
2021-08-13
期刊：
影响因子：
5.2
通讯作者：
Koschmieder S
中科院分区：
文献类型：
--
作者：
Gecht J;Tsoukakis I;Kricheldorf K;Stegelmann F;Klausmann M;Griesshammer M;Schulz H;Hollburg W;Göthert JR;Sockel K;Heidel FH;Gattermann N;Maintz C;Al-Ali HK;Platzbecker U;Hansen R;Hänel M;Parmentier S;Bommer M;Pahl HL;Lang F;Kirschner M;Isfort S;Brümmendorf TH;Döhner K;Koschmieder S
在骨髓增生性肿瘤（MPN）患者和肾功能不全患者中，与一般人群相比，血栓形成率更高。此外，MPN患者更容易出现肾功能障碍。在我们的研究中，我们评估了MPN患者肾功能障碍和血栓形成的特定危险因素的重要性。我们发现血栓形成率与肾功能不全程度相关，尤其是骨髓纤维化。肾功能障碍的显著相关性包括动脉高血压、MPN治疗和炎症增加，血栓形成的显著相关性包括动脉高血压、血小板计数不过高和抗血栓治疗。确定的危险因素关联因MPN亚型而异。我们的数据表明，MPN患者的肾功能障碍与血栓形成风险增加有关，需要更密切的监测，并可能早期预防血栓形成。炎症性血栓形成是骨髓增生性肿瘤（MPN）患者和肾功能不全患者的严重并发症。重叠的疾病特异性属性提示了MPN发病机制、肾功能障碍和血栓形成的共同机制。1420例原发性血小板增多症（ET, 33.7%）、真性红细胞增多症（PV, 38.5%）和骨髓纤维化（MF, 27.9%）患者的数据从德国研究组的MPN生物登记中提取。根据计算出的估计肾小球滤过率（eGFR, (mL/min/1.73 m2)）将整个队列细分为eGFR1（≥90,21%）、eGFR2（60 - 89, 56%）和eGFR3（<60, 22%）。29%的患者有血栓形成史。与eGFR2和eGFR1相比，eGFR3的血栓形成率更高，MPN持续时间更长。ET组肾功能不全比PV或MF组发生得早。多元logistic回归分析发现，动脉高血压、MPN治疗、尿酸和乳酸脱氢酶水平升高是MPN患者肾功能障碍的危险因素。血栓形成的危险因素包括动脉高血压、血小板计数不过高和抗血栓治疗。肾功能障碍和血栓形成的危险因素因MPN亚型而异。医生应该意识到MPN患者肾脏疾病的风险增加，这需要更密切的监测，可能的话，早期血栓预防。
In patients with myeloproliferative neoplasms (MPN) and in patients with kidney dysfunction, a higher rate of thrombosis has been reported compared with the general population. Furthermore, MPN patients are more prone to develop kidney dysfunction. In our study, we assessed the importance of specific risk factors for kidney dysfunction and thrombosis in MPN patients. We found that the rate of thrombosis is correlated with the degree of kidney dysfunction, especially in myelofibrosis. Significant associations for kidney dysfunction included arterial hypertension, MPN treatment, and increased inflammation, and those for thrombosis comprised arterial hypertension, non-excessive platelet counts, and antithrombotic therapy. The identified risk factor associations varied between MPN subtypes. Our data suggest that kidney dysfunction in MPN patients is associated with an increased risk of thrombosis, mandating closer monitoring, and, possibly, early thromboprophylaxis. Inflammation-induced thrombosis represents a severe complication in patients with myeloproliferative neoplasms (MPN) and in those with kidney dysfunction. Overlapping disease-specific attributes suggest common mechanisms involved in MPN pathogenesis, kidney dysfunction, and thrombosis. Data from 1420 patients with essential thrombocythemia (ET, 33.7%), polycythemia vera (PV, 38.5%), and myelofibrosis (MF, 27.9%) were extracted from the bioregistry of the German Study Group for MPN. The total cohort was subdivided according to the calculated estimated glomerular filtration rate (eGFR, (mL/min/1.73 m2)) into eGFR1 (≥90, 21%), eGFR2 (60–89, 56%), and eGFR3 (<60, 22%). A total of 29% of the patients had a history of thrombosis. A higher rate of thrombosis and longer MPN duration was observed in eGFR3 than in eGFR2 and eGFR1. Kidney dysfunction occurred earlier in ET than in PV or MF. Multiple logistic regression analysis identified arterial hypertension, MPN treatment, increased uric acid, and lactate dehydrogenase levels as risk factors for kidney dysfunction in MPN patients. Risk factors for thrombosis included arterial hypertension, non-excessive platelet counts, and antithrombotic therapy. The risk factors for kidney dysfunction and thrombosis varied between MPN subtypes. Physicians should be aware of the increased risk for kidney disease in MPN patients, which warrants closer monitoring and, possibly, early thromboprophylaxis.
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影响因子：
8.2
作者：
Brosius FC;Tuttle KR;Kretzler M
通讯作者：
Kretzler M
影响因子：
39.2
作者：
Hultcrantz M;Björkholm M;Dickman PW;Landgren O;Derolf ÅR;Kristinsson SY;Andersson TML
通讯作者：
Andersson TML
影响因子：
28.5
作者：
Kaifie A;Kirschner M;Wolf D;Maintz C;Hänel M;Gattermann N;Gökkurt E;Platzbecker U;Hollburg W;Göthert JR;Parmentier S;Lang F;Hansen R;Isfort S;Schmitt K;Jost E;Serve H;Ehninger G;Berdel WE;Brümmendorf TH;Koschmieder S;Study Alliance Leukemia (SAL)
通讯作者：
Study Alliance Leukemia (SAL)
影响因子：
20.3
作者：
Campbell, Peter J.;MacLean, Cathy;Green, Anthony R.
通讯作者：
Green, Anthony R.
DOI：
10.3904/kjim.2016.263
发表时间：
2018-07
期刊：
The Korean journal of internal medicine
影响因子：
--
作者：
Baek SW;Moon JY;Ryu H;Choi YS;Song IC;Lee HJ;Yun HJ;Kim S;Jo DY
通讯作者：
Jo DY