Chronic kidney disease could be a risk factor for thrombosis in essential thrombocythemia and polycythemia vera

Int J Hematol. 2020 Sep;112(3):377-384. doi: 10.1007/s12185-020-02898-7. Epub 2020 Jun 8.

Abstract

Chronic kidney disease (CKD) is a well-known risk factor for venous thromboembolism and cardiovascular (CV) disease development in the general population, but its role in thrombotic risk in essential thrombocythemia (ET) and polycythemia vera (PV) remains poorly understood. This retrospective multicenter study analyzed clinical correlations and the potential impact of CKD on thrombosis development in ET and PV patients. We included 167 patients (76 ET and 91 PV); 25.7% had CKD at diagnosis, defined as estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2 for ≥ 3 months. Lower eGFR correlated with advanced age, female sex, higher granulocytes, higher serum C-reactive protein, history of thrombosis, CV risk factors, and the presence of palpable splenomegaly. CKD was univariately associated with inferior thrombosis-free survival in the entire cohort, as well as in both ET and PV patients. These results remained significant in the multivariate Cox regression models when adjusted to disease-specific risk models. Therefore, CKD could be a risk factor for thrombosis in ET and PV patients. Additional studies on a larger number of patients are needed to confirm our findings and to elucidate whether the addition of CKD to the current risk stratification models might improve prognostication in ET and PV patients.

Keywords: Chronic kidney disease; Essential thrombocythemia; Polycythemia vera; Survival; Thrombosis.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Female
  • Glomerular Filtration Rate
  • Humans
  • Male
  • Middle Aged
  • Polycythemia Vera / complications*
  • Prognosis
  • Renal Insufficiency, Chronic / complications*
  • Renal Insufficiency, Chronic / diagnosis
  • Retrospective Studies
  • Risk Factors
  • Survival Rate
  • Thrombocythemia, Essential / complications*
  • Thrombosis / etiology*
  • Thrombosis / mortality