title: Imatinib treatment duration is related to decreased estimated glomerular filtration rate in chronic myeloid leukemia patients.
abstract: BACKGROUND
  We analyzed the incidence of acute kidney injury and chronic renal failure in chronic myeloid leukemia (CML) patients using imatinib and investigated whether there is a relation between duration of imatinib therapy and decrease in estimated glomerular filtration rate (GFR).
  
  
  METHODS
  One hundred five CML patients on imatinib therapy were enrolled. Creatinine, urea, uric acid, and potassium measurements from imatinib treatment onset until the end of follow-up (median 4.5 years) were included in the analysis. GFR was estimated using the Chronic Kidney Disease Epidemiology Collaboration equation.
  
  
  RESULTS
  During follow-up, 7% of patients developed acute kidney injury; creatinine levels returned to baseline in only one of them. According to the regression equation, the mean baseline value of the estimated GFR was 88.9 ml/min/1.73 m(2). Estimated GFR decreased significantly with imatinib treatment duration; the mean decrease per year was 2.77 ml/min/1.73 m(2) (P < 0.001); 12% of patients developed chronic renal failure. Age, hypertension, and a history of chronic renal failure or interferon usage were not significantly related to the mean decrease in the estimated GFR over time.
  
  
  CONCLUSIONS
  The introduction of imatinib therapy in nonclinical trial CML patients is associated with potentially irreversible acute renal injury, and the long-term treatment may cause a clinically relevant decrease in the estimated GFR.
authors.affiliation: School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. Electronic address: milenamarc@gmail.com.
authors.forename: M S
authors.initials: MS
authors.lastname: Marcolino
authors.affiliation: Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: E
authors.initials: E
authors.lastname: Boersma
authors.affiliation: School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil; Hematology Service, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
authors.forename: N C D
authors.initials: NCD
authors.lastname: Clementino
authors.affiliation: School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil; Hematology Service, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
authors.forename: A V
authors.initials: AV
authors.lastname: Macedo
authors.affiliation: School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
authors.forename: A D
authors.initials: AD
authors.lastname: Marx-Neto
authors.affiliation: School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
authors.forename: M H C R
authors.initials: MHCR
authors.lastname: Silva
authors.affiliation: Departments of Internal Medicine; Hospital Pharmacy, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: T
authors.initials: T
authors.lastname: van Gelder
authors.affiliation: Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: K M
authors.initials: KM
authors.lastname: Akkerhuis
authors.affiliation: School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil; Cardiology Service, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
authors.forename: A L
authors.initials: AL
authors.lastname: Ribeiro
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000503:physiopathology; D000328:Adult; D000367:Age Factors; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001549:Benzamides; D003404:Creatinine / Q000097:blood; D005260:Female; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006801:Humans; D000068877:Imatinib Mesylate; D007676:Kidney Failure, Chronic / Q000139:chemically induced* / Q000503:physiopathology; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010879:Piperazines / Q000008:administration & dosage / Q000009:adverse effects*; D011743:Pyrimidines / Q000008:administration & dosage / Q000009:adverse effects*; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate; D003404:Creatinine