Abstract Background Myelodysplastic syndromes (MDS) have been associated with various forms of kidney disease; however, whether they predispose to a longitudinal decline in kidney function in the general population is unknown. This study aimed to investigate the association between MDS and the risk of kidney function decline using a large-scale population-based cohort. Methods We retrospectively analyzed nationwide administrative claims and health checkup data collected between April 2014 and August 2024. MDS were identified using International Classification of Diseases, 10th Revision codes. Individuals were categorized into two groups according to the presence of MDS. The primary outcome was a composite kidney outcome, defined as incident end-stage kidney disease, initiation of kidney replacement therapy, or a ≥30% decline in estimated glomerular filtration rate. Results Among 1,659,421 individuals (median age, 68 IQR, 61–72 years; 41.9% male), MDS were identified in 901 individuals (0.05%). During a median follow-up of 1,092 days (IQR, 631–1520), 33,335 individuals experienced the composite kidney outcome. Cumulative incidence curves demonstrated a higher incidence of kidney function decline in individuals with MDS compared with those without MDS (P 0.001, log-rank test). In multivariable Cox regression analysis, the presence of MDS was independently associated with an increased risk of kidney function decline (hazard ratio 2.28 95% confidence interval 1.66–3.13). Conclusions In this large-scale nationwide cohort, MDS were significantly associated with an increased risk of kidney function decline, positioning MDS as a clinically relevant kidney risk condition and supporting closer kidney monitoring in this population.
Mitsuno et al. (Tue,) studied this question.