The Korean journal of internal medicine

The Korean Association of Internal Medicine (대한내과학회)
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Chronic kidney disease in the BCR-ABL1-negative myeloproliferative neoplasm: a single-center retrospective study

  • Baek, Seung-Woo (Department of Internal Medicine, Chungnam National University Hospital) ;
  • Moon, Ji Young (Department of Internal Medicine, Chungnam National University Hospital) ;
  • Ryu, Hyewon (Department of Internal Medicine, Chungnam National University Hospital) ;
  • Choi, Yoon-Seok (Department of Internal Medicine, Chungnam National University Hospital) ;
  • Song, Ik-Chan (Department of Internal Medicine, Chungnam National University Hospital) ;
  • Lee, Hyo-Jin (Department of Internal Medicine, Chungnam National University Hospital) ;
  • Yun, Hwan-Jung (Department of Internal Medicine, Chungnam National University Hospital) ;
  • Kim, Samyoung (Department of Internal Medicine, Chungnam National University Hospital) ;
  • Jo, Deog-Yeon (Department of Internal Medicine, Chungnam National University Hospital)
  • Received : 2016.08.16
  • Accepted : 2016.11.04
  • Published : 2018.07.01
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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 ($mL/min/1.73m^2$) 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 (< $-3mL/min/1.73m^2per\;year$). 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 (> $7.0{\times}10^9/L$) and high monocyte (> $0.7{\times}10^9/L$) 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.

Keywords

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