Ulyanovsk Medico-biological Journal

CLINICAL MEDICINE

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DOI 10.34014/2227-1848-2022-3-43-48

CHRONIC KIDNEY DISEASE IN PATIENTS WITH CHRONIC LYMPHATIC LEUKEMIA AND THEIR SURVIVABILITY

M.V. Markovtseva1, E.N. Zgural'skaya2

1 Ulyanovsk State University, Ulyanovsk, Russia;

2 Ulyanovsk State Technical University, Ulyanovsk, Russia

 

Chronic lymphocytic leukemia (CLL) is one of the most common lymphoproliferative diseases in the European population with an increase in the incidence in the elderly and senile age. However, it is among the elderly that a decrease in glomerular filtration rate (GFR) and concomitant chronic kidney disease (CKD) are associated with the severity in long-term prognosis.

The aim of the study was to analyze CKD incidence and prognostic value in patients with CLL.

Materials and Methods. CLL retrospective analysis was performed in 132 patients (60 men and 72 women). CKD was diagnosed according to the 2021-Guidelines of Russian Scientific Society of Nephrologists. Results. Among the examined patients, 64 (48.5 %) were diagnosed with CKD: stage C2 – in 23 patients. (17.4 %), stage C3a – in 41 patients. (31.1 %). CKD incidence in patients with CLL was higher than in the similar population without CLL. The authors revealed that there was no correlation between CLL stage and CKD severity. Survival analysis showed that only 43 patients (32.5 %) overcame the estimated Binet median survival. C3a in patients with CLL at the time of CKD diagnosis is strongly correlated with survival.

Conclusion. CKD occurs in 48.5 % of patients with CLL. It has been established that C3a CKD worsens CLL patient survivability.

Key words: chronic lymphocytic leukemia, chronic kidney disease, overall survivability.

 

References

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  2. Klinicheskie rekomendatsii. Khronicheskaya bolezn' pochek (KhBP) [Clinical guidelines. Chronic kidney disease (CKD)]. Nefrologiya. 2021; 25 (5): 10–82 (in Russian).

  3. Coresh J., Astor B.C., Greene T. Prevalence of chronic kidney disease and decreased kidney function in the adult US population: Third National Health and Nutrition Examination Survey. Am. J. Kidney Dis. 2003; 41 (1): 1–12.

  4. Li S., Foley R.N., Collins A.J. Anemia and cardiovascular disease, hospitalization, end stage renal disease, and death in older patients with chronic kidney disease. Int. Urol. Nephrol. 2005; 37: 395–402.

  5. Markovtseva M.V., Zgural'skaya E.N. Patent RF № 2725877 C1; 2020 (in Russian).

  6. Uprety D., Peterson A., Shah B.K., Dou X., Hu H. Renal failure secondary to leukemic infiltration of kidneys in CLL – a case report and review of literature Concurrent nephrotic syndrome and acute renal failure caused by chronic lymphocytic leukemia (CLL): a case report and literature review. Ann Hematol. 2013; 92: 271–273.

  7. Kamat A.V., Goldsmith D., O'Donnell P., van der Walt J., Carr R. Renal failure with granulomatous interstitial nephritis and diffuse leukemic renal infiltration in chronic lymphocytic leukemia. Ren Fail. 2007; 29: 763–765.

  8. Da'as N., Polliack A., Cohen Y., Amir G., Darmon D. Kidney involvement and renal manifestations in non-Hodgkin's lymphoma and lymphocytic leukemia: a retrospective study in 700 patients. Eur. J. Haematol. 2001; 67: 158–164.

  9. Phillips J.K., Bass P.S., Majumdar G., Davies D.R., Jones N.F. Renal failure caused by leukaemic infiltration in chronic lymphocytic leukaemia. J. Clin. Pathol. 1993; 46: 1131–1133.

  10. Haraldsdottir V., Haanen C., Jordans J.G. Chronic lymphocytic leukaemia presenting as renal failure with lymphocytic infiltration of the kidneys. Neth. J. Med. 1992; 41: 64–67.

  11. Moulin B., Ronco P.M., Mougenot B., Francois A., Fillastre J.P. Glomerulonephritis in chronic lymphocytic leukemia and related B-cell lymphomas. Kidney Int. 1992; 42: 127–135.

  12. Seney F.D.Jr., Federgreen W.R., Stein H., Kashgarian M. A review of nephrotic syndrome associated with chronic lymphocytic leukemia. Arch Intern Med. 1986; 146: 137–141.

  13. Schwartz J.B., Shamsuddin A.M. The effects of leukemic infiltrates in various organs in chronic lymphocytic leukemia. Hum Pathol. 1981; 12: 432–440.

  14. Norris H.J., Wiener J. The renal lesions in leukemia. Am. J. Med. Sci. 1961; 241: 512–518.

  15. Ferreira A.C., Brum S., Carvalho D., Pataca I., Carvalho F. Renal dysfunction due to leukemic infiltration of kidneys in a case of chronic lymphocytic leukemia. Hemodial Int. 2010; 14: 87–90.

  16. Comerma-Coma M.I., Sans-Boix A., Tuset-Andujar E., Andreu-Navarro J., Perez-Ruiz A. Reversible renal failure due to specific infiltration of the kidney in chronic lymphocytic leukaemia. Nephrol Dial Transplant. 1998; 13: 1550–1552.

  17. Rockx M.A., Rizkalla K., Clark W.F. Acute renal failure and chronic lymphocytic leukaemia. Nephrol Dial Transplant. 2008; 23: 770–771.

  18. Pagniez D.C., Fenaux P., Delvallez L., Dequiedt P., Gosselin B. Reversible renal failure due to specific infiltration in chronic lymphocytic leukemia. Am. J. Med. 1988; 85: 579–580.

  19. Hsu S.M., Waldron J.W.Jr., Hsu P.L., Hough A.J.Jr. Cytokines in malignant lymphomas: review and prospective evaluation. Hum Pathol. 1993; 24: 1040–1057.

  20. Lommatzsch S.E., Bellizzi A.M., Cathro H.P., Rosner M.H. Acute renal failure caused by renal infiltration by hematolymphoid malignancy. Ann Diagn Pathol. 2006; 10: 230–234.

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  22. Moulin B., Chantrel F., Petitjean P., Ronco P.M. Chronic lymphoproliferative disorders and glomerular diseases: review of the literature and pathophysiological considerations. J. Nephrol. 1995; 8: 20–26.

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 Received 4 May 2022; accepted 13 August 2022.

 

Information about the authors

Markovtseva Mariya Vladimirovna, Candidate of Sciences (Medicine), Associate Professor, Department of Hospital Therapy, Ulyanovsk State University. 432017, Russia, Ulyanovsk, L. Tolstoy St., 42; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it., ORCID ID: http://orcid.org/0000-0002-7299-5268

Zgural'skaya Ekaterina Nikolaevna, Candidate of Technical Sciences, Associate Professorб Chair of Information Technologies and General Scientific Disciplines, Ulyanovsk State Technical University. 432027, Russia, Ulyanovsk, Severnyy Venets St., 32; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it., ORCID ID: http://orcid.org/0000-0003-1527-9692

 

For citation

Markovtseva M.V., Zgural'skaya E.N. Khronicheskaya bolezn' pochek u patsientov s khronicheskim limfoleykozom i ikh vyzhivaemost' [Chronic kidney disease in patients with chronic lymphatic leukemia and their survivability]. Ul'yanovskiy mediko-biologicheskiy zhurnal. 2022; 3: 43–48. DOI: 10.34014/2227-1848-2022-3-43-48 (in Russian).

 

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УДК 616.411

DOI 10.34014/2227-1848-2022-3-43-48

ХРОНИЧЕСКАЯ БОЛЕЗНЬ ПОЧЕК У ПАЦИЕНТОВ С ХРОНИЧЕСКИМ ЛИМФОЛЕЙКОЗОМ И ИХ ВЫЖИВАЕМОСТЬ

М.В. Марковцева1, Е.Н. Згуральская2

1 ФГБОУ ВО «Ульяновский государственный университет», г. Ульяновск, Россия;

2 ФГБОУ ВО «Ульяновский государственный технический университет», г. Ульяновск, Россия

 

Хронический лимфолейкоз (ХЛЛ) – одно из наиболее распространенных лимфопролиферативных заболеваний европейской популяции с увеличением частоты встречаемости в пожилом и старческом возрасте. Однако именно среди пожилых снижение скорости клубочковой фильтрации (СКФ) и наличие хронической болезни почек (ХБП) ассоциировано с наибольшим ухудшением долгосрочного прогноза. 

Цель исследования – проанализировать встречаемость и прогностическое значение ХБП у пациентов с ХЛЛ.

Материалы и методы. Был проведен ретроспективный анализ течения ХЛЛ у 132 пациентов (60 мужчин и 72 женщины). Хроническую болезнь почек диагностировали, основываясь на Рекомендациях НОНР, 2021.

Результаты. Среди исследованных пациентов у 64 (48,5 %) была обнаружена ХБП: стадия С2 –у 23 чел. (17,4 %), стадия С3а – у 41 чел. (31,1 %). Частота встречаемости ХБП у пациентовбс ХЛЛ выше, чем в аналогичной популяции без ХЛЛ. Обнаружен факт отсутствия связи между стадией ХЛЛ и выраженностью ХБП. Анализ выживаемости показал, что только 43 пациента (32,5 %) преодолели расчетную медиану выживаемости по классификации Binet. Наличие у пациентов с ХЛЛ на момент постановки диагноза ХБП С3а находится в сильной прямой связи с выживаемостью.

Выводы. Хроническая болезнь почек наблюдается у 48,5 % пациентов с ХЛЛ. Установлено, что ХБП С3а ухудшает выживаемость больных с ХЛЛ.

Ключевые слова: хронический лимфолейкоз, хроническая болезнь почек, общая выживаемость

 

Литература

  1. Савченко В.Г., ред. Алгоритмы диагностики и протоколы лечения заболеваний системы крови. В 2 т. Т. 2. Москва: Практика; 2018.

  2. Клинические рекомендации. Хроническая болезнь почек (ХБП). Нефрология. 2021; 25 (5): 10–82.

  3. Coresh J., Astor B.C., Greene T. Prevalence of chronic kidney disease and decreased kidney function in the adult US population: Third National Health and Nutrition Examination Survey. Am. J. Kidney Dis. 2003; 41 (1): 1–12.

  4. Li S., Foley R.N., Collins A.J. Anemia and cardiovascular disease, hospitalization, end stage renal disease, and death in older patients with chronic kidney disease. Int. Urol. Nephrol. 2005; 37: 395–402.

  5. Марковцева М.В., Згуральская Е.Н. Патент РФ № 2725877 C1; 2020.

  6. Uprety D., Peterson A., Shah B.K., Dou X., Hu H. Renal failure secondary to leukemic infiltration of kidneys in CLL – a case report and review of literature Concurrent nephrotic syndrome and acute renal failure caused by chronic lymphocytic leukemia (CLL): a case report and literature review. Ann Hematol. 2013; 92: 271–273.

  7. Kamat A.V., Goldsmith D., O'Donnell P., van der Walt J., Carr R. Renal failure with granulomatous interstitial nephritis and diffuse leukemic renal infiltration in chronic lymphocytic leukemia. Ren Fail. 2007; 29: 763–765.

  8. Da'as N., Polliack A., Cohen Y., Amir G., Darmon D. Kidney involvement and renal manifestations in non-Hodgkin's lymphoma and lymphocytic leukemia: a retrospective study in 700 patients. Eur. J. Haematol. 2001; 67: 158–164.

  9. Phillips J.K., Bass P.S., Majumdar G., Davies D.R., Jones N.F. Renal failure caused by leukaemic infiltration in chronic lymphocytic leukaemia. J. Clin. Pathol. 1993; 46: 1131–1133.

  10. Haraldsdottir V., Haanen C., Jordans J.G. Chronic lymphocytic leukaemia presenting as renal failure with lymphocytic infiltration of the kidneys. Neth J. Med. 1992; 41: 64–67.

  11. Moulin B., Ronco P.M., Mougenot B., Francois A., Fillastre J.P. Glomerulonephritis in chronic lymphocytic leukemia and related B-cell lymphomas. Kidney Int. 1992; 42: 127–135.

  12. Seney F.D.Jr., Federgreen W.R., Stein H., Kashgarian M. A review of nephrotic syndrome associated with chronic lymphocytic leukemia. Arch Intern Med. 1986; 146: 137–141.

  13. Schwartz J.B., Shamsuddin A.M. The effects of leukemic infiltrates in various organs in chronic lymphocytic leukemia. Hum Pathol. 1981; 12: 432–440.

  14. Norris H.J., Wiener J. The renal lesions in leukemia. Am. J. Med. Sci. 1961; 241: 512–518.

  15. Ferreira A.C., Brum S., Carvalho D., Pataca I., Carvalho F. Renal dysfunction due to leukemic infiltration of kidneys in a case of chronic lymphocytic leukemia. Hemodial Int. 2010; 14: 87–90.

  16. Comerma-Coma M.I., Sans-Boix A., Tuset-Andujar E., Andreu-Navarro J., Perez-Ruiz A. Reversible renal failure due to specific infiltration of the kidney in chronic lymphocytic leukaemia. Nephrol Dial Transplant. 1998; 13: 1550–1552.

  17. Rockx M.A., Rizkalla K., Clark W.F. Acute renal failure and chronic lymphocytic leukaemia. Nephrol Dial Transplant. 2008; 23: 770–771.

  18. Pagniez D.C., Fenaux P., Delvallez L., Dequiedt P., Gosselin B. Reversible renal failure due to specific infiltration in chronic lymphocytic leukemia. Am. J. Med. 1988; 85: 579–580.

  19. Hsu S.M., Waldron J.W.Jr., Hsu P.L., Hough A.J.Jr. Cytokines in malignant lymphomas: review and prospective evaluation. Hum Pathol. 1993; 24: 1040–1057.

  20. Lommatzsch S.E., Bellizzi A.M., Cathro H.P., Rosner M.H. Acute renal failure caused by renal infiltration by hematolymphoid malignancy. Ann Diagn Pathol. 2006; 10: 230–234.

  21. Aymard B., Beghoura R., Molina T.J. Renal infiltrate by a plasmocytoid chronic B lymphocytic leukaemia and renal failure: a rare occurrence in nephropathology. A case report and review of the literature. Nephrol Ther. 2011; 7: 479–487.

  22. Moulin B., Chantrel F., Petitjean P., Ronco P.M. Chronic lymphoproliferative disorders and glomerular diseases: review of the literature and pathophysiological considerations. J. Nephrol. 1995; 8: 20–26.

  23. Панова Е.А., Серов В.А., Шутов А.М., Бакумцева Н.Н., Кузовенкова М.Ю. Полипрагмазия у амбулаторных пациентов пожилого возраста. Ульяновский медико-биологический журнал. 2019; 2: 16–22.

 Поступила в редакцию 16.06.2021; принята 07.07.2022.

 

Авторский коллектив

Марковцева Мария Владимировна – кандидат медицинских наук, доцент кафедры госпитальной терапии, ФГБОУ ВО «Ульяновский государственный университет». 432017, Россия, г. Ульяновск, ул. Л. Толстого, 42; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it., ORCID ID: http://orcid.org/0000-0002-7299-5268

Згуральская Екатерина Николаевна – кандидат технических наук, доцент кафедры информационных технологий и общенаучных дисциплин, ФГБОУ ВО «Ульяновский государственный технический университет». 432027, Россия, г. Ульяновск, ул. Северный Венец, 32; е-mail: This email address is being protected from spambots. You need JavaScript enabled to view it., ORCID ID: http://orcid.org/0000-0003-1527-9692

 

Образец цитирования

Марковцева М.В., Згуральская Е.Н. Хроническая болезнь почек у пациентов с хроническим лимфолейкозом и их выживаемость. Ульяновский медико-биологический журнал. 2022; 3: 43–48. DOI: 10.34014/2227-1848-2022-3-43-48.