Kidney Week

Abstract: FR-OR005

Multicenter Study of Risk Factors and Clinicopathological Characteristics of Chronic Lymphocytic Leukemia (CLL)-Related Kidney Lesions: Is CLL of Renal Significance?

Session Information

• Advancing Onconephrology Precision: Biomarkers, Therapeutic Targets, and Patient Outcomes
  October 23, 2026 | Location: Room 401, Convention Center
  Abstract Time: 05:10 PM - 05:20 PM

Category: Onconephrology

• 1600 Onconephrology

Authors

• Klomjit, Nattawat, University of Minnesota Twin Cities Division of Nephrology and Hypertension, Minneapolis, Minnesota, United States

Nattawat Klomjit, MD, FASN

• Miao, Jing, Mayo Clinic Division of Nephrology and Hypertension, Rochester, Minnesota, United States

Jing Miao, MD, PhD, FASN

• Cara, Anila, Mayo Clinic Division of Nephrology and Hypertension, Rochester, Minnesota, United States

Anila Cara, MD

• Juanet, Cristián, Mayo Clinic Division of Nephrology and Hypertension, Rochester, Minnesota, United States

Cristián Juanet, MD

• Vargas-Brochero, Maria J., Mayo Clinic Division of Nephrology and Hypertension, Rochester, Minnesota, United States

Maria J. Vargas-Brochero, MD, MS

• Laxamana, Trisha D., Mayo Clinic Division of Nephrology and Hypertension, Rochester, Minnesota, United States

Trisha D. Laxamana, MD

• Thongprayoon, Charat, Mayo Clinic Division of Nephrology and Hypertension, Rochester, Minnesota, United States

Charat Thongprayoon, MD, FASN

• Zand, Ladan, Mayo Clinic Division of Nephrology and Hypertension, Rochester, Minnesota, United States

Ladan Zand, MD

Background

Chronic lymphocytic leukemia (CLL) has been associated with various kidney pathologies. However, characteristics and outcomes of these lesions are limited.

Methods

We identified 132 patients with CLL who underwent kidney biopsy in 2010-2025 at Mayo Clinic, Rochester and the University of Minnesota. Kidney biopsies were required to occur either after CLL diagnosis or within 1 year prior. Kidney lesions were categorized as definitely related to CLL (d-CLL), probably related (p-CLL), or unrelated to CLL (u-CLL) (Figure 1). Multivariable regression was performed to identify predictors of d/p-CLL lesions.

Results

Of 132 patients, 65 (49.2%) had d-CLL lesions,17 (12.9%) had p-CLL, and 50 (37.9%) had u-CLL. CLL infiltration was present in 48 patients, accounting for 36.3% of full cohort (27 with only isolated CLL infiltration and 21 in combination with other pathology). Among d-CLL lesions, isolated CLL infiltration (41.5%) is the most common lesions followed by PGNMID (12.3%) and type 1 Cryo GN (10.8%) (Figure 1). Patients with d/p-CLL lesions had higher degree of hematuria, proteinuria and lower complement levels in addition to higher WBC and more splenomegaly (all p<0.05). In multivariable analysis, lower C3 (OR 1.07, p<0.001) and higher WBC (OR 1.04, p=0.028) predicted d/p-CLL lesions; proteinuria showed a trend (OR 1.11, p=0.083). Of 82 d/p-CLL, 53 (64.6%) required CLL treatment due to symptomatic CLL but 29 (35.4%) did not. At last follow-up, d/p-CLL lesions were associated with lower serum creatinine compared with U-CLL (1.37 vs 1.67 mg/dL, p=0.029), with no differences in other renal outcomes, or mortality.

Conclusion

Two-thirds of CLL patients undergoing kidney biopsy had lesions related to CLL with high proportion of CLL infiltration. Of d/p-CLL lesions, one third initiated CLL therapy due to kidney indication and not due to CLL symptoms. This highlights the importance of treating CLL with renal involvement even in the absence of hematological indication. We propose the term CLL of renal significance (CLLRS) to be used in such patients.