Department of Haematology, Zealand University Hospital, Roskilde, Denmark.
Department Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Eur J Haematol. 2022 Nov;109(5):576-585. doi: 10.1111/ejh.13845. Epub 2022 Aug 21.
The myeloproliferative neoplasms are associated with chronic kidney disease but whether clonal haematopoiesis of indeterminate potential (CHIP) is associated with impaired kidney function is unknown. In the Danish General Suburban Population Study (N = 19 958) from 2010 to 2013, 645 individuals were positive for JAK2V617F (N = 613) or CALR (N = 32) mutations. Mutation-positive individuals without haematological malignancy were defined as having CHIP (N = 629). We used multiple and inverse probability weighted (IPW)-adjusted linear regression analysis to estimate adjusted mean (95% confidence interval) differences in estimated glomerular filtration rate (eGFR; ml/min/1.73 m ) by mutation status, variant allele frequency (VAF%), blood cell counts, and neutrophil-to-lymphocyte ratio (NLR). We performed 11-year longitudinal follow-up of eGFR in all individuals. Compared to CHIP-negative individuals, the mean differences in eGFR were -5.6 (-10.3, -0.8, p = .02) for CALR, -11.9 (-21.4, -2.4, p = 0.01) for CALR type 2, and -10.1 (-18.1, -2.2, p = .01) for CALR with VAF ≥ 1%. The IPW-adjusted linear regression analyses showed similar results. NLR was negatively associated with eGFR. Individuals with CALR type 2 had a worse 11-year longitudinal follow-up on eGFR compared to CHIP-negative individuals (p = .004). In conclusion, individuals with CALR mutations, especially CALR type 2, had impaired kidney function compared to CHIP-negative individuals as measured by a lower eGFR at baseline and during 11-year follow-up.
骨髓增殖性肿瘤与慢性肾脏病相关,但不确定潜能的克隆性造血(CHIP)是否与肾功能受损相关尚不清楚。在 2010 年至 2013 年进行的丹麦一般郊区人群研究(N=19958)中,有 645 人 JAK2V617F(N=613)或 CALR(N=32)突变阳性。无血液恶性肿瘤的突变阳性个体被定义为具有 CHIP(N=629)。我们使用多变量和逆概率加权(IPW)调整线性回归分析来估计突变状态、变异等位基因频率(VAF%)、血细胞计数和中性粒细胞与淋巴细胞比值(NLR)对肾小球滤过率(eGFR;ml/min/1.73m)的调整后平均(95%置信区间)差异。我们对所有个体进行了 eGFR 的 11 年纵向随访。与 CHIP 阴性个体相比,CALR 的 eGFR 平均差异为-5.6(-10.3,-0.8,p=0.02),CALR 2 型为-11.9(-21.4,-2.4,p=0.01),CALR 且 VAF≥1%为-10.1(-18.1,-2.2,p=0.01)。IPW 调整后的线性回归分析显示了相似的结果。NLR 与 eGFR 呈负相关。与 CHIP 阴性个体相比,CALR 2 型个体的 eGFR 11 年纵向随访结果更差(p=0.004)。总之,与 CHIP 阴性个体相比,CALR 突变个体,尤其是 CALR 2 型个体,其肾脏功能受损,表现为基线时和 11 年随访期间 eGFR 较低。