Hyperferritinemia and oxidative stress in the kidney of beta thalassemia major

Abstract

Background: Thalassemia is a genetic disorder which until now has become a global health problem. Regular blood transfusions in managemen of BTM result in iron overload. Free iron in the form of intracellular ferrous (Fe2+), in the presence of oxygen, will initiate the formation of reactive oxygen species (ROS), produce another free radical superoxide that will oxidize the lipid and protein compounds of the cell membrane. F2-IsoPs is the best, most stable and more accurate marker of lipid peroxidation in vivo, found urine. This study aimed to determine the association between hyperferritinemia and lipid peroxidation in kidney reflected as elevated u-F2IsoPs as controlling several factors affecting oxidative stress in the kidney.Methods: This cross sectional study was conducted between May and June 2016. Thirty subjects of BTM admitted to pediatrics unit of Dr. Moewardi Hospital Surakarta who met the inclusion and exclusion criteria were enrolled. The data were analyzed to calculate prevalence ratio and 95%CI for each variable, followed by multivariate analysis with logistic regression.Results: The prevalence of lipid peroxidation in kidney, characterized with elevated u-F2IsoPs of > 2 ng/mg urine creatinine, was 67%. Age, hyperferritinemia status and duration of illness did not associate with lipid peroxidation in the kidney. Transfusion volume of ≥25 unit/year showed statistically significant association with lipid peroxidation (PR 24.10; 95%CI 2.16-268.42; p=0.010).Conclusion: Transfusion volume, rather than hyperferritinemia, independently associated to oxidative stress and lipid peroxidation of the kidney in BTM.