Year: 2024
Type: article
Study design: Observational Study
Abstract: Introduction: The objective of this study was to describe kidney involvement in patients with myelodysplastic syndromes (MDS), their treatments, and outcomes. Methods: We conducted a multicenter retrospective study in seven centers, identifying MDS patients with acute kidney injury (AKI), chronic kidney disease (CKD), and urine abnormalities. Results: Fifteen patients developed a kidney disease 3 months after MDS diagnosis. Median urine protein-to-creatinine ratio was 1.9 g/g, and median serum creatinine was 3.2 mg/dL. Ten patients had AKI at presentation, and 12 had extra-renal symptoms. The renal diagnoses included anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV), ANCA negative vasculitis, C3 glomerulonephritis, immune complex-mediated glomerulonephritis, polyarteritis nodosa, and IgA vasculitis. All patients but one received a specific treatment for the MDS-associated kidney injury. The effect of MDS treatment on kidney injury could be assessed in six patients treated with azacitidine, and renal function evolution was heterogenous. After a median follow-up of 14 months, four patients had CKD stage 3, five had CKD stage 4, and three had end stage kidney disease. On the other hand, three evolved to an acute myeloid leukemia and three died. Compared to 84 MDS controls, patients who had kidney involvement were younger, had a higher number of dysplasia lineages, and were more eligible to receive hypomethylating agents, but no survival difference was seen between the two groups. Compared to 265 AAV without MDS, the ten with MDS-associated pauci-immune vasculitis were older, ANCA serology was more frequently negative, and more cutaneous lesions were seen. Conclusion: The spectrum of kidney injuries associated with MDS is mostly represented by vasculitis with glomerular involvement, and especially AAV.
Source: Clinical Kidney Journal
DOI: 10.1093/ckj/sfae185
Authors: Marie-Camille Lafargue, Jean-Paul Duong Van Huyen, Helmut G Rennke, Marie Essig, Mickaël Bobot, Noémie Jourde-Chiche, Hamza Sakhi, Alexandre KARRAS, Idris Boudhabhay, Philippe Brunet, Hugoline Boulay, Vincent Grobost, Carole Philipponnet, Juliette Jeannel, Jonathan Chemouny, Jean-Jacques Boffa, Dorra Braham-Stambouli, Umut Selamet, Leonardo V Riella, Olivier Fain, Lionel Adès, Pierre Fenaux, Camille Cohen, Arsène Mekinian
Institutions: Université Paris Cité, Assistance Publique – Hôpitaux de Paris, Hôpital Tenon, Hôpital Necker-Enfants Malades, Brigham and Women's Hospital, Harvard University, Université Paris-Saclay, Hôpital Ambroise-Paré, Hôpital de la Conception, Hôpital Européen Georges-Pompidou, Inserm, École des Hautes Études en Santé Publique, Institut de Recherche en Santé, Environnement et Travail, Centre Hospitalier Universitaire de Rennes, Université de Rennes, Centre Hospitalier Universitaire de Clermont-Ferrand, Hôpitaux Universitaires de Strasbourg, Sorbonne Université, Massachusetts General Hospital, Hôpital Saint-Antoine, Hôpital Saint-Louis, Laboratoire d'hématologie, Hôpital Bichat-Claude-Bernard
Language: English
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,322
OpenAlex ID: W4399906584