Kidney involvement in myelodysplastic syndromes

Area of Science:

• Nephrology
• Hematology
• Internal Medicine

Background:

• Myelodysplastic syndromes (MDS) are a group of clonal hematopoietic stem cell disorders.
• Kidney involvement in MDS is not well-characterized.
• Understanding renal manifestations is crucial for patient management.

Purpose of the Study:

• To describe kidney involvement in patients with myelodysplastic syndromes (MDS).
• To analyze treatments and outcomes of renal disease in MDS patients.
• To compare characteristics of MDS patients with kidney involvement to controls.

Main Methods:

• Multicenter retrospective study involving seven centers.
• Identification of MDS patients with acute kidney injury (AKI), chronic kidney disease (CKD), and urine abnormalities.
• Comparison with MDS controls and anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) patients without MDS.

Main Results:

• Fifteen MDS patients developed kidney disease, predominantly vasculitis (including ANCA-associated vasculitis).
• Common findings included high proteinuria, elevated creatinine, and extra-renal symptoms.
• Outcomes varied, with progression to CKD, end-stage kidney disease, or transformation to acute myeloid leukemia.

Conclusions:

• Kidney injuries in MDS are primarily vasculitis with glomerular involvement, notably ANCA-associated vasculitis.
• Specific treatments were administered, but renal function evolution was heterogeneous.
• MDS patients with kidney involvement showed distinct characteristics but similar survival to MDS controls.