Beneficial effect of ACE inhibitors on kidney function in polycythemia vera.

Abstract

Reduced kidney function has been associated with worse clinical outcomes in patients with myeloproliferative neoplasms (MPN). Statins and angiotensin-converting enzyme inhibitors (ACE-i) have renoprotective properties and their pleiotropic effects might also affect the malignant MPN clone; however, whether concomitant use of statins and ACE‑i has apositive effect on estimated glomerular filtration rate (eGFR) in polycythemia vera (PV) patients is currently unknown. This multicenter retrospective study investigated effects of statins and ACE‑i on 12-month eGFR dynamics in 75PV patients. Of the patients 25 (33.3%) had a10% or more increase in eGFR at 12months. Univariately, statins (55.5% vs. 16.3%; p = 0.022), ACE‑i (61% vs. 24.6%; p = 0.004), male sex (54.3%, vs. 15%; p < 0.001) and the absence of chronic kidney disease (CKD, 45.5% vs. 16.1%; p = 0.008) were statistically significantly associated with an improvement in eGFR. ACE‑i (p = 0.008), CKD (p < 0.001), male sex (p = 0.004) and higher baseline eGFR (p = 0.007) remained statistically significantly associated with an improvement in eGFR in the multivariate logistic regression model also including statins, hydroxyurea, high-risk disease, cardiovascular risk factors, chronic heart failure and baseline hematocrit. The ACE‑i might have renoprotective properties in PV. Further studies are needed to elucidate whether the use of these drugs could also affect other MPN-related outcomes.