Impact of tyrosine kinase inhibitors on estimated glomerular filtration rate in chronic myeloid leukemia patients

Abstract Abstract: Introduction Tyrosine kinase inhibitors (TKIs) are the cornerstone of chronic myeloid leukemia (CML) treatment. While nephrotoxicity is a potential complication, existing evidence remains conflicting, with limited data from the Gulf region. We evaluated the impact of TKIs on renal function in CML patients. Methods This retrospective single-center study, conducted in Qatar, included patients treated with TKIs for CML between 2016 and 2023. The primary outcome was the change in estimated glomerular filtration rate (eGFR). Secondary outcomes included acute kidney injury (AKI), chronic kidney disease (CKD), and dialysis requirement. Changes in eGFR over time were assessed using repeated measures analysis of variance (RM-ANOVA). Results Among 209 patients followed for a median of 69.3 months (IQR: 39.4–117.8), imatinib was the most commonly prescribed TKI (65.1%), followed by dasatinib (18.7%) and nilotinib (16.3%). Mean baseline eGFR was 93.8 (SD=26.3) and remained stable at three months (p=0.498), three years (p=0.112), and eight years (p=0.297) in the overall cohort. However, dasatinib-treated patients experienced a significant eGFR decline from 87.5 (SD=16.7) to 76.8 (SD=11.4) over three years (p=0.042). AKI and CKD occurred in 8.1% and 1.9% of patients, respectively, with no dialysis requirements. No significant differences in renal adverse events were observed between TKIs. Conclusion Renal function remained stable in most CML patients on TKIs. However, dasatinib was associated with a significant eGFR decline, whereas imatinib and nilotinib showed no such effect.