Kidney involvement in myelodysplastic syndromes - Archive ouverte du site Alsace
Article Dans Une Revue Clinical Kidney Journal Année : 2024

Kidney involvement in myelodysplastic syndromes

Helmut G Rennke
Mickaël Bobot
Philippe Brunet
Vincent Grobost
Carole Philipponnet
Umut Selamet
Leonardo Riella

Résumé

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.
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hal-04870530 , version 1 (07-01-2025)

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Marie-Camille Lafargue, Jean-Paul Duong van Huyen, Helmut G Rennke, Marie Essig, Mickaël Bobot, et al.. Kidney involvement in myelodysplastic syndromes. Clinical Kidney Journal, 2024, 17 (8), pp.sfae185. ⟨10.1093/ckj/sfae185⟩. ⟨hal-04870530⟩
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