Background Cardiorenal syndrome (CRS) is a serious condition with high morbidity and mortality. Secondary CRS (type 5 CRS) is characterized by the coexistence of cardiac abnormality and renal dysfunction occurring secondarily to a systemic condition. There is limited information about CRS in thalassemia. This study aimed to investigate the prevalence of secondary CRS in thalassemia patients and also associated risk factors.Methods In this cross-sectional cohort study, thalassemia patients who attended the out-patient clinic of University hospital from October 2016 to September 2017 were enrolled onto the study. A criterion for diagnosis of secondary CRS is based on a system proposed by Ronco and McCullough. Cardiac abnormalities are assessed by clinical presentation, establishment of acute or chronic heart failure using definitions from 2016 ESC guidelines or from structural abnormalities shown in an echocardiogram. Renal dysfunction is defined by acute kidney injury or chronic kidney disease according to 2012 KDIGO guidelines. Clinical and laboratory findings from 2 consecutive visits, three months apart, were assessed.Results Out of 90 thalassemia patients, 25 (27.8%) had secondary CRS. The multivariable analysis showed a significant correlation between CRS and extramedullary hematopoiesis (EMH) (odds ratio (OR) 20.55, p=0.016); thalassemia type [β 0 /β E vs β 0 /β 0 thalassemia (OR = 0.005, p=0.002)]; pulmonary hypertension (OR 178.1, p=0.001); elevated serum NT-proBNP (OR 1.028, p=0.022), and elevated 24-hour urine magnesium (OR 1.913, p=0.016). There was no correlation between CRS and frequency of blood transfusion, serum ferritin, liver iron concentration, cardiac T2*, type of iron chelating agents, and urine neutrophil gelatinase-associated lipocalin level.Conclusions Secondary CRS is not rare in thalassemia patients. We also identified useful condition and markers for the detection of CRS in thalassemia cases.
Background: Cardiorenal syndrome (CRS), a serious condition with high morbidity and mortality, is characterized by the coexistence of cardiac abnormality and renal dysfunction. There is limited information about CRS in association thalassemia. This study aimed to investigate the prevalence of CRS in thalassemia patients and also associated risk factors. Methods: Thalassemia patients who attended the outpatient clinic of a tertiary care university hospital from October 2016 to September 2017 were enrolled onto this cross-sectional study. Clinical and laboratory findings from 2 consecutive visits, 3 months apart, were assessed. The criteria for diagnosis of CRS was based on a system proposed by Ronco and McCullough. Cardiac abnormalities are assessed by clinical presentation, establishment of acute or chronic heart failure using definitions from 2016 ESC guidelines or from structural abnormalities shown in an echocardiogram. Renal dysfunction was defined as chronic kidney disease according to the 2012 KDIGO guidelines. Results: Out of 90 thalassemia patients, 25 (27.8%) had CRS. The multivariable analysis showed a significant association between CRS and extramedullary hematopoiesis (EMH) (odds ratio (OR) 20.55, p = 0.016); thalassemia type [β 0 /β E vs β 0 /β 0 thalassemia (OR 0.005, p = 0.002)]; pulmonary hypertension (OR 178.1, p = 0.001); elevated serum NT-proBNP (OR 1.028, p = 0.022), and elevated 24-h urine magnesium (OR 1.913, p = 0.016). There was no association found between CRS and frequency of blood transfusion, serum ferritin, liver iron concentration, cardiac T2*, type of iron chelating agents, or urine neutrophil gelatinase-associated lipocalin level. Conclusions: CRS is relatively common in thalassemia patients. Its occurrence is associated with laboratory parameters which are easily measured in clinical practice.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.