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3230 Higher Prevalence of Chronic Kidney Disease in Myelodysplastic Syndromes Patients Compared to Age- Adjusted General Population - Results from the Polish Adult Leukemia Group (PALG) Registry

Program: Oral and Poster Abstracts
Session: 637. Myelodysplastic Syndromes – Clinical and Epidemiological: Poster II
Hematology Disease Topics & Pathways:
MDS, Chronic Myeloid Malignancies, Diseases, Myeloid Malignancies
Sunday, December 10, 2023, 6:00 PM-8:00 PM

Krzysztof Madry, MD, PhD1*, Anna Jachalska2*, Pawel Szwedyk3*, Oktawia Sosnia4*, Elzbieta Wiater5*, Agata Obara6*, Dorota Krochmalczyk, MD7*, Anna Kopinska8*, Małgorzata Gajewska9*, Anna Kulikowska De Nalecz10*, Agnieszka Kopacz11*, Magdalena Olszewska-Szopa12*, Aleksandra Golos, MD, PhD13*, Edyta Subocz, MD14*, Rafal Machowicz, MD, PhD, MSc15*, Iwona Hus, MD16*, Alicja Rydzewska-Rosołowska17*, Anna Wasińska-Krawczyk18*, Grzegorz Basak, MD, PhD19* and Andrzej Rydzewski18*

1Hematology, Transplantation and Internal Medicine, Medical University, Warsaw, Warsaw, Poland
2Biziel Hospital, Bydgoszcz, Poland
3Department of Hematology, Rydygier Specialistic Hospital, Krakow, POL
4Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
5Department of Hematology, Specialistic Hospital, Toruń, Poland
6Department of Hematology, Holycross Cancer Center, Kielce, Poland
7Department of Hematology, Collegium Medicum, Jagiellonian University, Krakow, Poland
8Department of Hematology and Bone Marrow Transplantation, Medical University of Silesia, Katowice, Poland
9Department of Hematology, Military Institute of Medicine, Warsaw, Poland
10Department of Hematology, State Hospital, Opole, Poland
11Department of Hematology, Voivodeship Specialistic Hospital in Rzeszów, Rzeszow, POL
12Department of Hematology, Blood Neoplasms and Bone Marrow Transplantation, Medical University Wrocław, Wrocław, Poland
13Department of Hematology, Medical University of Łodz, Łodz, Poland
14Warmian-Masurian Cancer Center of the Ministry of the Interior and Administration Hospital, Olsztyn, Poland
15Medical University of Warsaw, Warsaw, POL
16The National Institute of Medicine of the Ministry of Interior and Administration, Warszawa, Poland
17Department of Nephrology and Hypertension with Dialysis Unit, Medical University Białystok, Białystok, Poland
18Department of Internal Medicine, Nephrology and Transplantation, The National Institute of Medicine of the Ministry of Interior and Administration, Warsaw, Poland
19Department of Hematology, Transplantation and Internal Medicine, Medical University of Warsaw, Warsaw, Poland


Chronic comorbidities that are common in the elderly population can have a significant impact on the clinical course, the choice of treatment, and survival of myelodysplastic syndromes (MDS) patients. No studies have focused on the coexistence of two diseases that are common in the elderly population, chronic kidney disease (CKD) and MDS, so the epidemiological data and clinical implications of both diseases occurring together are unknown.


Primary objective: to assess the prevalence of CKD in patients with MDS in comparison to the age-adjusted general population.

Secondary objective: to evaluate the impact of CKD on clinical course in MDS patients.


This was a prospective analysis using clinical and laboratory data from MDS patients who were registered in the Polish Adult Leukemia Group (PALG) Registry from 2010 to 2023. Data have been provided by 28 hematologic centers.

CKD was defined as an eGFR < 60 mL/min/1.73m², disregarding albuminuria since urinalysis results were not recorded in the database. The stages of CKD were classified based on eGFR according to the NKF KDOQI National Kidney Foundation Kidney Disease Outcome Quality Initiative guidelines, and eGFR was calculated using CKD-EPI equation.

For comparison of the prevalence of CKD in MDS subjects aged ≥60 years to the general population, we used data from the PolSenior 2 study (covering the years 2018-2019). Data were age and sex standardized using demographic tables from Statistics Poland (https:// demografia.stat.gov.pl/bazademografia/Tables.aspx).

Median survival time was calculated using Kaplan-Meier estimator. Multivariate analysis was performed using Cox regression.


Overall, data (including eGFR) were available for 1813 MDS patients. Median age at diagnosis was 71 years [IQR 64 - 78]. and 55.3% patients were male. Sixty percent of the patients were diagnosed as IPPS lower risk.

At the time of MDS diagnosis, CKD was detected in 479 patients (26.4%). Among patients aged ≥ 60, the crude rate of CKD was 30.3%. The standardized rate of CKD in the general population aged 60 years was significantly lower than in the similarly aged MDS group, with rates of 13.2% [CI 12.3-14.1] and 25.5% [CI 22.9-28.4]; p<0.001, respectively. (Figure 1)

Patients with CKD were significantly older (median 78 yo) than those without CKD (median 68 yo; p<0.001), and more likely to have diabetes (33.2% vs 19.7%; p<0.001), and to have coincidence of another malignancy (21.6%) than those without CKD (14.9%; p=0.001). Median hemoglobin concentration was significantly lower in the CKD group (8.9 g/dL) than in the non-CKD group (9.4 g/dL; p < 0.05). Subjects with decreased eGFR were more likely to be dependent on RBC transfusion (56.5%) than subjects with eGFR ≥ 60 ml/min per 1.73m2 (48.9%; p=0.0008).

Median survival of patients with eGFR ≥ 60 ml/min per 1.73m2 was 2.5 y [CI 1.0-6.1] vs 1.4 y [CI 0.6-4.2] for CKD. In multivariate analysis we found that CKD stage, age ≥ 65, higher IPSS score, high-risk IPSS cytogenetics and ECOG >1 were independent predictors of shorter survival. (Figure 2).


Myelodysplastic syndrome (MDS) subjects are more likely to have chronic kidney disease (CKD) than the general population. The presence of CKD in MDS patients is associated with worse overall survival and higher RBC transfusion requirement.

Disclosures: Madry: Teva: Other: lecture fees; AbbVie: Other: advisory boards, lecture fees; BMS: Other: advisory boards, lecture fees.

*signifies non-member of ASH