Medstar Washington Hospital Center, Washington, DC, USA.
Medstar Health Research Institute, Hyattsville, MD, USA.
Leuk Lymphoma. 2020 Dec;61(12):2923-2930. doi: 10.1080/10428194.2020.1786555. Epub 2020 Jul 11.
With improving lymphoma survival, late effects of therapy have emerged. Here, we describe pattern of long-term chronic kidney disease (CKD) in lymphoma survivors. Demographics, comorbidities, lymphoma histology, treatment, and outcome were recorded. Glomerular filtration rate (GFR) was recorded at diagnosis, 1, 2, 5, and 10 years. Rate of GFR decline with time and CKD-free survival were recorded. In 397 patients, median age was 55.3 (18-88), 54% were male, 60% were African Americans, 42% had hypertension (HTN), 15% had DM, 13% had hyperuricemia, 86% received chemotherapy, and 14% had baseline CKD. Total 125 (31%) patients developed CKD in 10 years after lymphoma diagnosis. Probability of CKD development increased significantly with time (23% at 1 year to 41% at 10 years). Rate of GFR decline was 4.6 mL/min/per year. Age, HTN, hyperuricemia, and DM (in young patients) predicted risk of CKD. Thus, lymphoma survivors are at substantial long-term risk of CKD development.
随着淋巴瘤生存率的提高，治疗的晚期效应已经出现。在这里，我们描述了淋巴瘤幸存者中慢性肾脏病（CKD）的长期模式。记录了人口统计学、合并症、淋巴瘤组织学、治疗和结局。在诊断时、1 年、2 年、5 年和 10 年记录肾小球滤过率（GFR）。记录了随时间推移的 GFR 下降率和 CKD 无进展生存率。在 397 名患者中，中位年龄为 55.3（18-88）岁，54%为男性，60%为非裔美国人，42%患有高血压（HTN），15%患有糖尿病（DM），13%患有高尿酸血症，86%接受了化疗，14%有基线 CKD。在淋巴瘤诊断后的 10 年内，共有 125（31%）名患者发生 CKD。CKD 发生的概率随时间显著增加（1 年时为 23%，10 年时为 41%）。GFR 下降率为 4.6mL/min/年。年龄、HTN、高尿酸血症和 DM（在年轻患者中）预测了 CKD 的风险。因此，淋巴瘤幸存者存在相当大的长期 CKD 发病风险。
