RESUMEN
Introduction This study describes the incidence and risk factors of de novo nephrolithiasis among patients with lymphoproliferative or myeloproliferative diseases who have undergone chemotherapy. Materials and Methods From 2001 to 2011, patients with lymphoproliferative or myeloproliferative disorders treated with chemotherapy were retrospectively identified. The incidence of image proven nephrolithiasis after chemotherapy was determined. Demographic and clinical variables were recorded. Patients with a history of nephrolithiasis prior to chemotherapy were excluded. The primary outcome was incidence of nephrolithiasis, and secondary outcomes were risk factors predictive of de novo stone. Comparative statistics were used to compare demographic and disease specific variables for patients who developed de novo stones versus those who did not. Results A total of 1,316 patients were identified and the incidence of de novo nephrolithiasis was 5.5% (72/1316; symptomatic stones 1.8% 24/1316). Among patients with nephrolithiasis, 72.2% had lymphoproliferative disorders, 27.8% had myeloproliferative disorders, and 25% utilized allopurinol. The median urinary pH was 5.5, and the mean serum uric acid, calcium, potassium and phosphorus levels were 7.5, 9.6, 4.3, and 3.8 mg/dL, respectively. In univariate analysis, mean uric acid (p=0.013), calcium (p<0.001)), and potassium (p=0.039) levels were higher in stone formers. Diabetes mellitus (p<0.001), hypertension (p=0.003), and hyperlipidemia (p<0.001) were more common in stone formers. In multivariate analysis, diabetes mellitus, hyperuricemia, and hypercalcemia predicted stone. Conclusions We report the incidence of de novo nephrolithiasis in patients who have undergone chemotherapy. Diabetes mellitus, hyperuricemia, and hypercalcemia are patient-specific risk factors that increase the odds of developing an upper tract stone following chemotherapy. .
Asunto(s)
Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Cálculos Renales/etiología , Trastornos Linfoproliferativos/tratamiento farmacológico , Trastornos Mieloproliferativos/tratamiento farmacológico , Alopurinol/uso terapéutico , Calcio/análisis , Complicaciones de la Diabetes , Hipercalcemia/complicaciones , Hiperuricemia/complicaciones , Análisis Multivariante , Potasio/análisis , Estudios Retrospectivos , Medición de Riesgo , Factores de Riesgo , Estadísticas no Paramétricas , Síndrome de Lisis Tumoral/complicaciones , Síndrome de Lisis Tumoral/tratamiento farmacológicoRESUMEN
No abstract available.
Asunto(s)
Adulto , Humanos , Masculino , Persona de Mediana Edad , Alelos , Proteínas de Fusión bcr-abl/genética , Heterocigoto , Hidroxiurea/uso terapéutico , Janus Quinasa 2/genética , Leucemia Mielógena Crónica BCR-ABL Positiva/diagnóstico , Leucocitos Mononucleares/patología , Leucocitosis/diagnóstico , Mutación , Trastornos Mieloproliferativos/tratamiento farmacológico , Fenotipo , Esplenomegalia/diagnóstico , Trombocitosis/diagnóstico , Translocación GenéticaRESUMEN
Molecular markers are helpful in diagnosis, prognosis and management of haematological malignancies. Recently, a single point mutation in the Janus Kinase 2 (JAK2) gene in the Philadelphia-negative myeloproliferative disorders, including polycythemia vera (over 95%), essential thrombocythemia (50%) and primary myelofibrosis (50%) was identified by several groups. This mutation is now considered to have a fundamental role in the pathogenesis of these disorders. A PCR-based test from peripheral blood has become available in India to detect this mutation. Present article discusses the basic aspects of this mutation and its value in diagnosing, prognosticating and treating patients of suspected chronic myeloproliferative disorders.