Assessment of Subclinical Renal Glomerular and Tubular Dysfunction in Children with Beta Thalassemia Major

Mahmoud, Asmaa A.; Elian, Doaa M.; Hady, Nahla Ms Abd El; Abdallah, Heba; Abdelsattar, Shimaa; Khalil, Fatma Omar; Naby, Sameh A Abd El

doi:10.3390/children8020100

Cited by 10 publications

(11 citation statements)

References 41 publications

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“…Our study also showed that there was no signi cant correlation between serum ferritin level and β2M. This nding was in agreement with the study of Safaei et al (23). In contrast, Adly et al reported that there was a positive correlation between serum ferritin and urinary β2M in all thalassemia patients (15).…”

Section: Demographic and Baseline Characteristic Datasupporting

confidence: 93%

“…To the best of our knowledge, there has been no study mentioning the correlation between fractional excretion of electrolytes and serum ferritin level in patients with thalassemia. On the other hand, some studies found a signi cant correlation between serum ferritin level and other predictors of renal damage and prevented us from making further comparisons and analyses (17,21,23). Tanus et al and Mahmoud et al reported a signi cant correlation between serum ferritin levels and urinary N-acetyl-b-D-glucosaminidase (UNAG) (17,23).…”

Section: Demographic and Baseline Characteristic Datamentioning

confidence: 99%

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Assessment of the correlation between renal function markers and serum ferritin levels in thalassemia patients

Tammadondar,

Vatankhah,

Khatibzade-Nasari

2023

Preprint

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The aim of this study was to analyze renal function markers and correlate the results with serum ferritin levels in patients with thalassemia who were referred to the Abu Reihan Thalassemia Clinic of Payambar Azam Medical Center in Bandar Abbas, Iran in 2020. We conducted a cross-sectional study and included patients with a proven hemoglobinopathy diagnosis. Fasting blood was obtained to measure creatinine, sodium, potassium, calcium, phosphorus, magnesium, uric acid, and ferritin. In addition, a 24-hour urine specimen was collected to determine microalbuminuria, creatinine, sodium, potassium, calcium, phosphorus, magnesium, uric acid, and β2-microglobulin. Fractional excretion of sodium, potassium, calcium, phosphorus, magnesium, and uric acid was calculated. Finally, all the information was recorded using checklists, and data analysis was performed using Statistical Package for Social Sciences (SPSS) software version 20. Spearman’s coefficient of correlation was used to determine the correlations between serum ferritin level and other variables. Sixty-six patients aged 3 to 42 years were studied. In total, 2 patients (0.3%) had sickle cell thalassemia, 53 patients (80.3%) had major thalassemia, and 11 patients (72.7%) had intermediate thalassemia. Serum ferritin, 24-hour urine protein, and fractional excretion of sodium, calcium, and urine were elevated in thalassemia patients. There was no significant correlation between serum ferritin level and age, fractional excretion of potassium, β2-microglobulin, 24-hour urine protein, and serum creatinine (P value > 0.05). On the other hand, there was a significant correlation between serum ferritin level and fractional excretion of magnesium, calcium, sodium, phosphorus, and uric acid with a negative correlation coefficient (p-value ≤0.05). We also found that the serum ferritin levels strongly correlated with microalbuminuria (p value=0.005).

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Section: Demographic and Baseline Characteristic Datasupporting

confidence: 93%

Section: Demographic and Baseline Characteristic Datamentioning

confidence: 99%

Assessment of the correlation between renal function markers and serum ferritin levels in thalassemia patients

Tammadondar,

Vatankhah,

Khatibzade-Nasari

2023

Preprint

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“…For example, Mahmoud AA et al reported a significant increase in serum urea, Cr, and K in β-TM patients compared with the controls but no significant difference in serum Na and Ca between the two groups. In addition, they found a significant increase in urinary UA/Cr, U Ca/Cr, U albumin/Cr, and UK/Cr in β-TM patients than in the controls [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Renal Dysfunction in Pediatric Patients in Iraq With β-Thalassemia Major and Intermedia

Shaalan¹,

Hassan²,

Al-Shanoof³

et al. 2022

Cureus

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BackgroundWith optimum transfusion and chelation therapy, the survival of β-thalassemia patients and the incidence of various complications, including renal complications, have improved. ObjectivesTo investigate renal involvement in β-thalassemia patients using serum and urinary biochemical markers of glomerular and tubular dysfunction. MethodsThis case-control study included 69 β-thalassemia major (β-TM) patients, 23 β-thalassemia intermedia (β-TI) patients, and 100 healthy controls, all ranging from 1 to 16 years in age. Blood urea nitrogen (BUN), serum ferritin, serum and urinary levels of creatinine (Cr), uric acid (UA), calcium (Ca), phosphorus (Ph), magnesium (Mg), sodium (Na), and potassium (K), and the urinary albumin/creatinine ratio were evaluated. ResultsThe BUN level and the urinary Na/Cr, K/Cr, Ca/Cr, Mg/Cr, Ph/Cr, albumin/Cr, and UA/Cr ratios were significantly higher in the β-thalassemia patients than in the controls. In contrast, the serum Na, K, Ca, and Mg levels were significantly lower in the patients (P<0.05). An elevated urinary UA/Cr ratio was found in 61.9% of β-thalassemia patients, and an elevated urinary Ca/Cr, and urinary albumin/Cr ratio was found in 53.2%. An elevated Na/Cr ratio was found in 41.3%. The serum and urinary renal markers showed no significant differences between patients with β-TM and β-TI, except for microscopic hematuria, which was significantly higher in β-TI patients (34.8%) than in β-TM patients (13%), P>0.02. At an older age, high serum ferritin levels and deferoxamine therapy were associated with significant tubular and glomerular dysfunction in β-thalassemia patients. ConclusionsPediatric patients with β-thalassemia have significantly abnormal tubular and glomerular functions, necessitating early detection and monitoring to prevent/reverse renal function deterioration.

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“…Additionally, there was no connection between any of these indicators and the kidney function tests (serum creatinine, urea, and uACR) or between serum cystatin C and u2MG. 20 Elbedewy et al 41 and Mahmoud et al 42 showed a significant positive correlation between cystatin-C and serum ferritin and negative correlation with eGFR.…”

Section: Cystatin C and Uβ2mgmentioning

confidence: 97%

Markers of Renal Complications in Beta Thalassemia Patients with Iron Overload Receiving Chelation Agent Therapy: A Systematic Review

Romadhon¹,

Ashariati²,

Bintoro³

et al. 2022

JBM

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The emerging renal complications in beta-thalassemia patients have raised the global exchange of views. Despite better survival due to blood transfusion and iron chelation therapy, the previously unrecognized renal complication remain a burden of disease affecting this population -the primary concern on how iron overload and chelation therapy correlated with renal impairment is still controversial. Early detection and diagnosis is crucial in preventing further kidney damage. Therefore, a systematic review was performed to identify markers of kidney complications in beta thalassemia patients with iron overload receiving chelation therapy. Methods: Searches of PubMed, Scopus, Science Direct, and Web of Science were conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) to identify studies of literature reporting renal outcome in β-TM patients with iron overload and receiving chelation therapy. The eligible 17 studies were obtained. Results: uNGAL/NGAL, uNAG/NAG, uKIM-1 are markers that can be used as predictor of renal tubular damage in early renal complications, while Cystatin C and uβ2MG showed further damage at the glomerular level. Discussion and Conclusion:The renal complication in beta-thalassemia patients with iron overload receiving chelating agent therapy may progress to kidney disease. Early detection using accurate biological markers is a substantial issue that deserves further evaluation to determine prevention and management.

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Assessment of Subclinical Renal Glomerular and Tubular Dysfunction in Children with Beta Thalassemia Major

Cited by 10 publications

References 41 publications

Assessment of the correlation between renal function markers and serum ferritin levels in thalassemia patients

Assessment of the correlation between renal function markers and serum ferritin levels in thalassemia patients

Renal Dysfunction in Pediatric Patients in Iraq With β-Thalassemia Major and Intermedia

Markers of Renal Complications in Beta Thalassemia Patients with Iron Overload Receiving Chelation Agent Therapy: A Systematic Review

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