Serum Neutrophil Gelatinase-Associated Lipocalin as a Biomarker for Early Renal Dysfunction in Adult Egyptian Patients with b-Thalassemia Major

Abstract

Background: Renal dysfunction in thalassemia may occur before the occurrence of any symptoms, Induction of NGAL after kidney injury precedes the elevation of classical markers for kidney damage, which made it a promising marker for renal dysfunction in β -thalassemia, major.Aim of the Work: To assess value of serum NGAL in patients with β -thalassemia major as an early marker of renal impairment. Patients and Methods:The present study enrolled 70 subjects and they were classified into two main groups: • Group (I): 20 apparently healthy normal volunteers. • Group (II): 50 multi-transfused β -thalassemia major patients. Which subdivided according to chelation therapy into two subgroups:• Subgroup (I): On regular iron chelation therapy. • Subgroup (II): Without chelation therapy.Results: In our study serum NGAL was significantly elevated in group II compared to control group. Also in our study, we found a direct correlation between NGAL and urea, creatinine, eGFR, ferritin, transferrin saturation while there was inverse correlation between NGAL and hemoglobin, β 2microglobulin.Conclusion: NGAL could be considered as early predictor of renal dysfunction in thalassemia.

Urinary biomarkers of early kidney injury in children with beta-thalassemia

“…Recent studies have revealed that there are different tubular and glomerular abnormalities in patients with b-TM major and that renal dysfunction may occur in such patients without any clinical symptoms [5].…”

“…So, there is an urgent need for early predictive biomarkers of renal impairment in b-TM major as early intervention can significantly improve the prognosis [7].…”