Chronic kidney disease in the BCR-ABL1-negative myeloproliferative neoplasm: a single-center retrospective study.
Chronic kidney disease in the BCR-ABL1-negative myeloproliferative neoplasm: a single-center retrospective study.
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DOI：
10.3904/kjim.2016.263
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发表时间：
2018-07
期刊：
影响因子：
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通讯作者：
Jo DY
中科院分区：
文献类型：
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作者：
Baek SW;Moon JY;Ryu H;Choi YS;Song IC;Lee HJ;Yun HJ;Kim S;Jo DY
尚未在亚洲人群中全面检查与BCR-ABL 1阴性骨髓增生性肿瘤（MPN）相关的肾脏并发症。我们回顾性分析了2005年至2015年BCR-ABL 1阴性MPN患者的估计肾小球滤过率（eGFR）及其随时间的变化。慢性肾脏疾病（CKD）的患病率为11%（6.6%为3期，4.4%为4期）。在eGFR与时间（年）的线性回归分析中，总体而言，患者显示eGFR（mL/min/1.73 m2）增加0.51（95%置信区间[CI]，-0.30至1.33; p = 0.22）。真性红细胞增多症（PV）患者和接受羟基脲治疗的患者显示eGFR统计学显著性增加（PV组为1.59; 95% CI，0.28 - 2.90; p = 0.22;羟基脲治疗组为1.55; 95% CI，0.56 - 2.54; p = 0.22）。总共有17例患者（20.5%）显示eGFR快速下降（<-3 mL/min/1.73 m2/年）。eGFR的快速下降与肾脏疾病的发病率较高相关（23.5% vs. 6.1%，p= 0.05），中性粒细胞计数高的患者百分比更高（>7.0 × 109 /L）和高单核细胞（> 0.7 × 109 /L）计数（分别为76.5%和50%，p=0.05; 52.9%和28.8%，p= 0.06）。更多患者在诊断时血清乳酸脱氢酶水平较高（> 500 U/L）（52.9% vs. 25.8%，p = 0.03）。CKD在BCR-ABL 1阴性MPN患者中普遍存在。积极的细胞减灭治疗有可能改善BCR-ABL 1阴性MPN患者的肾功能。
Renal complications related to BCR-ABL1-negative myeloproliferative neoplasms (MPNs) have not been examined fully in Asian populations. We analyzed estimated glomerular filtration rate (eGFR) and its changes with time retrospectively in patients with BCR-ABL1-negative MPN from 2005 to 2015. 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. 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.