The spectrum of glomerular and vascular kidney pathology associated with myeloproliferative neoplasms.

Autor:	d'Izarny-Gargas T; Department of Pathology, Necker-Enfants Malades Hospital, APHP, Paris, France., Isnard P; Department of Pathology, Necker-Enfants Malades Hospital, APHP, Paris, France., Boudhabhay I; Department of Nephrology, Necker-Enfants Malades Hospital, APHP, Paris, France., Buob D; Department of Pathology, Tenon Hospital, APHP, Paris, France., Moktefi A; Department of Pathology, Henri Mondor Hospital, APHP, Créteil, France., Linster C; Department of Nephrology, Luxembourg Hospital Center, Luxembourg City, Luxembourg., Hummel A; Department of Nephrology, Necker-Enfants Malades Hospital, APHP, Paris, France., Esteve E; Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche S 1155, Sorbonne Université, Paris, France; Department of Nephrology, Tenon Hospital, APHP, Paris, France., Audard V; Department of Nephrology and Renal Transplantation, Henri Mondor Hospital, APHP, Créteil, France; Institut National de la Santé et de la Recherche Médicale, Institut Mondor de Recherche Biomédicale U955, Université Paris Est Créteil, Créteil, France., Lazareth H; Department of Nephrology, Georges Pompidou European Hospital, APHP, Paris, France., Maroun N; Department of Nephrology, Poissy Intercommunal Hospital, Poissy, France., Hertig A; Department of Nephrology, Foch Hospital, Suresnes, France., Gosset C; Department of Nephrology, CHU de la Réunion, Saint-Denis, France., Jouzel C; Department of Nephrology, René Dubos Hospital, Pontoise, France., Permal S; Department of Internal Medicine, Mamoudzou Hospital, Mayotte, France., Domenger C; Department of Nephrology, Ta'aone Hospital, Papeete, France., Kosmider O; Hematology Laboratory, Cochin Hospital, Paris, France; UFR Médecine, Université Paris Cité, Paris, France., Rabant M; Department of Pathology, Necker-Enfants Malades Hospital, APHP, Paris, France., Karras A; Department of Nephrology, Georges Pompidou European Hospital, APHP, Paris, France; UFR Médecine, Université Paris Cité, Paris, France., Duong Van Huyen JP; Department of Pathology, Necker-Enfants Malades Hospital, APHP, Paris, France; UFR Médecine, Université Paris Cité, Paris, France. Electronic address: jean-paul.duong@aphp.fr.
Jazyk:	angličtina
Zdroj:	Kidney international [Kidney Int] 2023 Dec; Vol. 104 (6), pp. 1206-1218. Date of Electronic Publication: 2023 Sep 26.
DOI:	10.1016/j.kint.2023.09.010
Abstrakt:	A high prevalence of chronic kidney disease (CKD) occurs in patients with myeloproliferative neoplasms (MPN). However, MPN-related glomerulopathy (MPN-RG) may not account for the entirety of CKD risk in this population. The systemic vasculopathy encountered in these patients raises the hypothesis that vascular nephrosclerosis may be a common pattern of injury in patients with MPN and with CKD. In an exhaustive, retrospective, multicenter study of MPN kidney biopsies in four different pathology departments, we now describe glomerular and vascular lesions and establish clinicopathologic correlations. Our study encompassed 47 patients with MPN who underwent a kidney biopsy that included 16 patients with chronic myeloid leukemia (CML) and 31 patients with non-CML MPN. Fourteen cases met a proposed definition of MPN-RG based on mesangial sclerosis and hypercellularity, as well as glomerular thrombotic microangiopathy. MPN-RG was significantly associated with both myelofibrosis and poorer kidney survival. Thirty-three patients had moderate-to-severe arteriosclerosis while 39 patients had moderate-to-severe arteriolar hyalinosis. Multivariable models that included 188 adult native kidney biopsies as controls revealed an association between MPN and chronic kidney vascular damage, which was independent of established risk factors such as age, diabetes mellitus and hypertension. Therefore, MPN-RG is associated with myelofibrosis and has a poor kidney prognosis. Thus, our findings suggest that the kidney vasculature is a target during MPN-associated vasculopathy and establish a new link between MPN and CKD. Hence, these results may raise new hypotheses regarding the pathophysiology of vascular nephrosclerosis in the general population. (Copyright © 2023 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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