Kidney and Urinary Tract Involvement in Chronic Myelomonocytic Leukemia

Kidney Med. 2023 Dec 5;6(2):100769. doi: 10.1016/j.xkme.2023.100769. eCollection 2024 Feb.

Abstract

Chronic myelomonocytic leukemia (CMML) is a hematologic malignancy affecting the bone marrow and resulting in peripheral blood monocytosis. Kidney and urinary tract involvement is common and can present dramatically with life-threatening consequences. Kidney involvement can be the result of direct or indirect mechanisms, including prerenal azotemia, glomerular disease, tubulointerstitial involvement, and renovascular disorders. Urinary tract involvement, electrolyte and acid-base disorders, as well as nephrotoxicity from treatment of the disorder can also occur. Given this multifactorial pathogenesis involving several mechanisms concomitantly, nephrologists must exercise heightened awareness and maintain a low threshold for kidney biopsy. There is a pressing need for future research endeavors to elucidate and target the manifestations of CMML that involve the kidneys with the ultimate goal of augmenting overall prognosis and therapeutic outcomes.

Keywords: Chronic myelomonocytic leukemia; glomerulopathy; kidney injury; lysozyme-induced nephropathy; onconephrology; tumor lysis syndrome; vasculitis.

Publication types

  • Review