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慢性肾脏病的存在及发病作为原发性血小板增多症患者预后不良的一个相关因素

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

作者信息

Hashimoto Yoshinori, Omura Hiromi, Tanaka Takayuki

机构信息

Department of Hematology, Tottori Prefectural Central Hospital, Tottori, Japan.

出版信息

Adv Hematol. 2024 Feb 8;2024:9591497. doi: 10.1155/2024/9591497. eCollection 2024.

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 V617F 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, =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, =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.

摘要

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。我们收集了符合世界卫生组织2017年分类标准的ET患者,并进行了一项回顾性临床研究,以阐明CKD的存在和发病与预后之间的关联。在73例符合诊断标准的患者中,21例(28.8%)在ET诊断时患有CKD。CKD患者的年龄显著更高,且这些患者中很大一部分存在V617F基因突变。CKD的存在是预后的一个危险因素(风险比(HR):3.750,95%置信区间(CI):1.196 - 11.760,P = 0.023),生存曲线明显更差。此外,我们将CKD的发病作为一个时间依赖性变量,对ET诊断时无CKD的患者进行分析,发现CKD的发病是预后的一个危险因素(HR:9.155,95%CI:1.542 - 54.370,P = 0.005)。对于ET诊断时肾功能减退的患者或随访期间肾功能下降的患者,有必要定期进行严格的肾功能监测。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/840d/10869185/6ab4cbdad63f/AH2024-9591497.001.jpg

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