Presence and Onset of Chronic Kidney Disease as a Factor Involved in the Poor Prognosis of Patients with Essential Thrombocythemia.

Q3 Medicine Advances in Hematology Pub Date : 2024-02-08 eCollection Date: 2024-01-01 DOI:10.1155/2024/9591497
Yoshinori Hashimoto, Hiromi Omura, Takayuki Tanaka
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Abstract

Chronic kidney disease (CKD) is an important risk factor for cardiovascular disease, thrombosis, and all-cause death. However, few studies have examined the association between CKD and the prognosis of patients with essential thrombocythemia (ET). We collected ET patients who met the WHO classification 2017 and performed a retrospective clinical study to clarify the association between the presence and onset of CKD and prognosis. Of 73 patients who met the diagnostic criteria, 21 (28.8%) had CKD at the time of ET diagnosis. The age of patients with CKD was significantly higher, and a high proportion of these patients had the JAK2V617F gene mutation. The presence of CKD was a risk factor for the prognosis (hazard ratio (HR): 3.750, 95% confidence interval (CI): 1.196-11.760, P=0.023), and the survival curve was significantly poorer. Furthermore, we analyzed patients without CKD at the time of ET diagnosis using the onset of CKD as a time-dependent variable and identified the onset of CKD as a risk factor for the prognosis (HR: 9.155, 95% CI: 1.542-54.370, P=0.005). In patients with renal hypofunction at the time of ET diagnosis or those with a reduction in the kidney function during follow-up, strict renal function monitoring at regular intervals is necessary.

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慢性肾病的存在和发病是导致原发性血小板增多症患者预后不良的因素之一
慢性肾脏病(CKD)是心血管疾病、血栓形成和全因死亡的重要危险因素。然而,很少有研究探讨 CKD 与原发性血小板增多症(ET)患者预后之间的关联。我们收集了符合2017年WHO分类的ET患者,并进行了一项回顾性临床研究,以明确CKD的存在和发病与预后之间的关联。在符合诊断标准的73名患者中,21人(28.8%)在确诊ET时患有CKD。患有慢性肾功能衰竭的患者年龄明显偏高,其中很大一部分患者存在 JAK2V617F 基因突变。存在 CKD 是预后的危险因素(危险比 (HR):3.750,95% 置信区间 (CI):1.196-11.760,P=0.023),生存曲线明显较差。此外,我们以 CKD 发病时间作为时间依赖变量,对 ET 诊断时无 CKD 的患者进行了分析,结果发现 CKD 发病时间是影响预后的风险因素(HR:9.155,95% CI:1.542-54.370,P=0.005)。对于 ET 诊断时肾功能减退或随访期间肾功能减退的患者,有必要定期进行严格的肾功能监测。
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来源期刊
Advances in Hematology
Advances in Hematology Medicine-Hematology
CiteScore
3.30
自引率
0.00%
发文量
10
审稿时长
15 weeks
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