Clonal hematopoiesis of indeterminate potential (CHIP) is a premalignant inflammatory condition caused by genetic abnormalities in hematopoietic stem cells. The disorder is widespread in older people and is linked to cardiovascular disease and mortality, although its function in CKD is uncertain. In two separate cohorts of 87 and 85 people with an eGFR<60 ml/min per 1.73m2, researchers used targeted sequencing to discover CHIP mutations. They also measured creatinine levels during a 5-year period after assessing kidney function, hematologic, and mineral bone disease parameters cross-sectionally at baseline.
CHIP was found in 18 of 87 (21%) and 25 of 85 (29%) cohort members at baseline. The Kidney Failure Risk Equation (KFRE) projected that participants with CHIP had a greater risk of kidney failure than those without CHIP. In a Cox proportional hazard model adjusted for age, sex, and baseline eGFR, individuals with CHIP had a 2.2-fold greater chance of a 50% drop in eGFR or ESKD after 5 years of follow-up (hazard ratio 2.2; 95% CI, 1.2 to 3.8). ESKD forecasts improved when CHIP was included in 2-year and 5-year calibrated KFRE risk models. In comparison to those without CHIP, patients with CHIP had lower hemoglobin, greater ferritin, and a larger mean corpuscular volume of red blood cells.
CHIP was linked to higher baseline KFRE scores, CKD progression, and anemia in an exploratory examination of people with preexisting CKD. More study is needed to determine the nature of the link between CHIP and the advancement of renal disease.
Reference:jasn.asnjournals.org/content/33/5/985
