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

Romadhon, Pradana Zaky; Ashariati, Ami; Bintoro, Siprianus Ugroseno Yudho; Thaha, Mochammad; Suryantoro, Satriyo Dwi; Windradi, Choirina; Mahdi, Bagus Aulia; Novendrianto, Dwiki; Widiyastuti, Krisnina Nurul; Martani, Okla Sekar; Widiasi, Etha Dini; Agustin, Esthiningrum Dewi; Prabowo, Emil; Putra, Yasjudan Rastrama; Thahadian, Harik Firman; Adhikara, Imam Manggalya; Adyarini, Dwita Dyah; Prahasanti, Kartika; Putri, Aditea Etnawati; Yusoff, Narazah Mohd

doi:10.2147/jbm.s387416

JBM

2022

DOI: 10.2147/jbm.s387416

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

Pradana Zaky Romadhon¹,

Ami Ashariati²,

Siprianus Ugroseno Yudho Bintoro³

et al.

Abstract: 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 … Show more

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Cited by 3 publications

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Evaluation of serum cystatin-C and netrin-1 as predictive biomarkers for renal injury in children with beta-thalassemia major

Shwayel,

Jewad,

Abdulsattar

2023

J Appl Hematol

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Evaluation of serum cystatin-C and netrin-1 as predictive biomarkers for renal injury in children with beta-thalassemia major

Shwayel,

Jewad,

Abdulsattar

2023

J Appl Hematol

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Effect of deferasirox on renal function in thalassemic children

Talukder,

Selimuzzaman,

Rasha

2023

PNJB

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Background: Iron-chelating therapy causes improvement in the life expectancy of thalassemic patients. Deferasirox (DFX) is an oral iron chelator with an established dose-dependent efficacy, though alteration of renal function has been observed in many studies. In the present study, we evaluated the effect of treatment with DFX on renal function. Materials and Methods: This quasi-experimental study was done in the Thalassemia Center of Bangladesh Shishu Hospital and Institute from June 2019 to July 2021, where 50 thalassemia major and E-β thalassemia children aged 2–18 years old were included. Blood urea nitrogen (BUN), serum creatinine, spot urinary protein creatinine ratio, spot urinary calcium creatinine ratio, and estimated glomerular filtration rate (eGFR) were measured. If renal functions were normal, DFX was started at a dose of 25 mg/kg/day. After 6 months of DFX treatment, the abovementioned investigations were repeated and analysis was done. The study variables were analyzed by paired t-test. P value <0.05 was considered significant. Results: The mean age of the thalassemic children was 5.21 ± 1.72 years. Before treatment, mean serum creatinine was 39.78 ± 3.12 μmol/L, and after 6 months, serum creatinine was increased but not statistically significant. The mean value was 40.50 ± 3.39 μmol/L after 6 months (P value 0.071). There was no significant change of BUN. Initially, the mean BUN was 3.39 ± 0.76 mmol/L, and 6 months after treatment, it was 3.45 ± 0.70 mmol/L. Initially, the spot urinary protein creatinine ratio was 0.12 ± 0.04, and after 6 months, the mean value was 0.43 ± 0.24. it was significantly increased (P value <0.001). Initially, the spot urinary calcium creatinine ratio was 0.068 ± 0.043, and after treatment, it was significantly raised. The mean value was 0.191 ± 0.168 (P value <0.001). After 6 months of treatment with DFX, 35 patients developed mild proteinuria, and eight patients developed hypercalciuria. There was no significant change of eGFR before and after treatment. Conclusions: In this study, we got significant proteinuria and hypercalciuria but nonsignificant changes in serum creatinine, BUN, and eGFR.

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Plasma CRP-hs and Ferritin Concentration Related to Kidney Injury in Adult Patients with Beta-thalassemia: A Cross-sectional Study in Vietnam

Do Thi Thanh,

Dao Bui Quy,

Pham Thu

et al. 2023

Nephro-Urol Mon

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Background: Kidney injury (KI) is one of the complications of β-thalassemia patients. Objectives: To determine the rate of KI and its relationship with plasma ferritin and CRP-hs in β-thalassemia patients. Methods: A total of 142 patients diagnosed with β-thalassemia (58.5% minor, 17.6% intermedia, and 23.9% major) were included in our study. In all patients, we measured plasma ferritin, CRP-hs, urine albumin, and serum creatinine and calculated the urine albumin to creatinine ratio (uACR). Based on uACR, we divided the patients into 2 groups: with KI (n = 19, uACR ≥ 3.0 mg/mmol) and without KI (n = 123, uACR < 0.3 mg/mmol). Results: The ratio of KI in β-thalassemia patients was 13.4%. The median concentrations of plasma ferritin and CRP-hs in the KI group were significantly higher than in the non-KI group (P < 0.001). Plasma ferritin and CRP-hs were independent risk factors for KI (P < 0.001). At a cut-off value of 2.35 mg/L, plasma CRP-hs had a predictive value for KI (AUC = 0.841, P < 0.001). Similarly, plasma ferritin at the cut-off value of 2394.95 µg/L showed a predictive value for KI (AUC = 0.789, P < 0.001). Conclusions: The rate of KI was low in adult patients with β-thalassemia. Plasma ferritin and CRP-hs had a good predictive value for KI in β-thalassemia patients.

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

Cited by 3 publications

References 41 publications

Evaluation of serum cystatin-C and netrin-1 as predictive biomarkers for renal injury in children with beta-thalassemia major

Evaluation of serum cystatin-C and netrin-1 as predictive biomarkers for renal injury in children with beta-thalassemia major

Effect of deferasirox on renal function in thalassemic children

Plasma CRP-hs and Ferritin Concentration Related to Kidney Injury in Adult Patients with Beta-thalassemia: A Cross-sectional Study in Vietnam

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