{"id":"97c5853ff1d4","type":"article","url":"https://hartvaat.nl/2026/08/12/clonale-hematopoiese-voorspelt-nierfunctievermindering-en-sterfte-bij-cytopenie-/","title":"Clonale hematopoïese voorspelt nierfunctievermindering en sterfte bij cytopenie met chronische nierziekte","title_en":"Clonal hematopoietic mutations as a predictor of adverse outcomes in cytopenic patients with chronic kidney disease.","category":"chronische nierziekte","category_label":"Nierziekte","professions":["cardioloog","internist"],"tags":[],"journal":"Blood research","doi":"10.1007/s44313-026-00161-2","source_url":"https://doi.org/10.1007/s44313-026-00161-2","authors":["Suwannaporn Yaophrukchai","Chantana Polprasert","Sirorat Kobbuaklee","Ponlapat Rojnuckarin","Sunisa Kongkiatkamon"],"significance":4,"published":"2026-08-20","source_date":"2026-08-12","image":"https://hartvaat.nl/global/img/51137ab74ed6.webp","kennis":["https://hartvaat.nl/kennis/nierziekte/nierziekte-en-cardiovasculair-risico/","https://hartvaat.nl/kennis/nierziekte/contrastmiddel-en-nierfunctie/"],"congress":"","summary_en":"In a retrospective cohort study of 67 patients with cytopenia and chronic kidney disease (CKD), clonal hematopoiesis (CH) was present in 53.7% and independently predicted CKD progression (adjusted HR 2.83) and higher mortality (adjusted HR 3.90) over a median follow-up of 43.5 months. The association was most pronounced in patients with myelodysplastic syndromes. Identifying CH in this population may improve risk stratification and guide closer monitoring of renal decline and survival outcomes.","created":"2026-08-13T01:42:26Z","updated":"2026-08-13T01:42:28Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"In een retrospectieve cohortstudie van 67 patiënten met cytopenie en chronische nierziekte (CKD) bleek clonale hematopoïese (CH) bij meer dan de helft voor te komen. Dragers van CH hadden een significant hoger risico op CKD-progressie (HR 2,83) en een verhoogde sterfte (HR 3,90) gedurende een mediane follow-up van 43,5 maanden. Deze bevindingen suggereren dat het screenen op CH bij deze kwetsbare groep kan helpen bij risicostratificatie en het identificeren van patiënten met een ongunstige nier- en overlevingsprognose.","abstract_original":"PURPOSE: Clonal hematopoiesis (CH) is associated with cardiovascular disease (CVD), inflammation, and increased mortality. However, its prevalence and clinical impact in patients with cytopenia and chronic kidney disease (CKD) remain unclear. METHODS: We conducted a retrospective cohort study of patients with cytopenia and CKD who underwent targeted sequencing to evaluate the association between CH, CKD progression, and overall mortality. RESULTS: A total of 67 patients were included (mean age 75.7 ± 10.5 years; 58.2% male). Most patients had myelodysplastic neoplasms (MDS) (79.1%), followed by clonal cytopenia of undetermined significance (CCUS) and idiopathic cytopenia of undetermined significance (ICUS) (14.9%). CH was detected in 53.7% of the patients, most commonly involving TET2 (44.4%), DNMT3A (22.2%), and ASXL1 (22.2%). Over a median follow-up of 43.5 months (interquartile range [IQR] 34.3-79.3), CKD progression occurred in 34.3%. The 5-year cumulative incidence of CKD progression tended to be higher in the CH carriers than in the non-carriers (55.4% vs. 31.4%; log-rank p = 0.066). In multivariable Cox analysis, CH remained independently associated with CKD progression (adjusted hazard ratio [HR] 2.83; 95% confidence intervals [CI] 1.03-7.79; p = 0.044). CKD progression was most frequent in patients with MDS and CH (46%), followed by MDS without CH (30%) and CCUS (16%), with no progression in ICUS. Mortality was higher in CH carriers (50.0% vs. 16.1%; p = 0.004) and remained independently associated with CH (adjusted HR 3.90; 95% CI 1.41-10.83; p = 0.009). CONCLUSIONS: CH is common in cytopenic patients with CKD and is independently associated with an increased risk of CKD progression and mortality. The assessment of CH may improve risk stratification and identify high-risk patients with adverse renal and survival outcomes."}