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Impact of Imatinib Treatment on Renal Function in Chronic Myeloid Leukemia Patients

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SINGH Avinash Kumar HUSSAIN Mohammad Salman AHMED Rayaz AGRAWAL Narendra BHURANI Dinesh KLUGAR Miloslav SHARMA Manju

Year of publication 2022
Type Article in Periodical
Magazine / Source Nephrology
MU Faculty or unit

Faculty of Medicine

Keywords cancer; chronic kidney disease; chronic myeloid leukaemia;imatinib; meta-analysis; tyrosine kinase inhibitors
Description Background Recently, multiple epidemiological studies have linked imatinib with the alteration of kidney function in chronic myeloid leukemia (CML) patients. This meta-analysis aimed to summarize the impact of Imatinib use on renal function in CML patients. Methods A systematic search was conducted on MEDLINE and Embase to identify articles assessing the impact of imatinib exposure on renal function in CML patients. The risk of bias was assessed using the Newcastle-Ottawa scale (NOS). Two authors independently performed literature screening, risk of bias, and data extraction. The risk of renal dysfunction (chronic kidney disease or acute kidney injury) among imatinib users was computed as the primary outcome of interest. The certainty of findings was assessed using the GRADE criteria. Results A total of nine articles qualified for inclusion in the systematic review, of which four articles were eligible for meta-analysis. Based on the scoring on NOS, majority of the included studies were found to be of moderate risk of bias. Majority of the studies (n = 6) reported significantly (p <0.05) decrease in estimated glomerular filtration rate (eGFR) after imatinib treatment. The risk of developing renal dysfunction (CKD or AKI) was found to be significantly higher in imatinib users as compared to other TKI (tyrosine kinase inhibitor) users with a pooled relative risk of 2.70 (95% CI: 1.49 – 4.91). Sensitivity analysis also revealed a consistently high risk of renal dysfunction with imatinib use. GRADE criteria revealed low certainty of evidence. Conclusion This meta-analysis found an increased risk of renal dysfunction in imatinib users compared to other TKI users.
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