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Original Paper

Renal Dysfunction in Patients with Beta-Thalassemia Major Receiving Iron Chelation Therapy either with Deferoxamine and Deferiprone or with Deferasirox

Economou M. · Printza N. · Teli A. · Tzimouli V. · Tsatra I. · Papachristou F. · Athanassiou-Metaxa M.

Author affiliations

First Department of Pediatrics, Aristotle University of Thessaloniki, ‘Hippokration’ General Hospital, Thessaloniki, Greece

Related Articles for ""

Acta Haematol 2010;123:148–152

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: August 06, 2009
Accepted: December 22, 2009
Published online: February 24, 2010
Issue release date: April 2010

Number of Print Pages: 5
Number of Figures: 0
Number of Tables: 1

ISSN: 0001-5792 (Print)
eISSN: 1421-9662 (Online)

For additional information: https://www.karger.com/AHA

Abstract

There are limited studies on renal involvement in β-thalassemia, mainly involving patients on deferoxamine, reporting both glomerular and tubular dysfunction. The aim of the present study was to investigate renal involvement in young thalassemia patients, using both conventional and early markers of renal dysfunction, and to correlate findings to iron chelation therapy. Forty-two patients aged 4–23 years were studied and, for analysis purposes, were divided into two groups based on chelation therapy (group A receiving deferasirox and group B receiving deferoxamine and deferiprone combination therapy). In addition to conventional renal biochemistries, creatinine clearance, estimated glomerular filtration rate, serum cystatin C (Cys C), fractional excretion of sodium, tubular phosphorus reabsorption and urine calcium, protein, β2-microglobulin (β2-MG) and glucose levels were measured. A considerable number of patients demonstrated impaired renal function with elevated Cys C levels (36%), glomerular dysfunction with proteinuria (24%) and tubulopathy with hypercalciuria (35.5%) and elevated excretion of β2-MG (33.5%). Renal involvement seems to be present even in young patients with β-thalassemia, therefore, routine use of early markers of renal dysfunction is recommended. Further studies are needed in order to investigate the role of new chelators in tubular function parameters.

© 2010 S. Karger AG, Basel


References

  1. Fosburg M, Nathan D: Treatment of Cooley’s anemia. Blood 1990;76:435–444.
  2. Modell B, Khan M, Darlison M: Survival in beta-thalassemia major in the UK: data from the UK Thalassemia Register. Lancet 2000;355:2051–2052.
  3. Kontoghiorghes G, Neocleous K, Kolnagou A: Benefits and risks of deferiprone in iron overload in thalassemia and other conditions: comparison of epidemiological and therapeutic aspects with deferoxamine. Drug Saf 2003;26:553–584.
  4. Porter J: Deferasirox: an effective once daily orally active iron chelator. Drugs Today 2006;42:623–637.
  5. Hogg R, Furth S, Lemley K, Portman R, Schwartz G, Coresh J, Balk E, Lau J, Levin A, Kausz A, Eknoyan G, Levey A: National Kidney Foundation’s Kidney Disease Outcomes Quality Initiative clinical practice guidelines for chronic kidney disease in children and adolescents: evaluation, classification, and stratification. Pediatrics 2003;111:1416–1421.
  6. Schwartz GJ, Haycock GB, Edelmann CM Jr, Spitzer A: A simple estimate of glomerular filtration rate in children derived from body length and plasma creatinine. Pediatrics 1976;58:259–263.
  7. Levey A, Bosch J, Lewis J, Greene T, Rogers N, Roth D: A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med 1999;130:461–470.
  8. Aldudak B, Karabay Bayazit A, Noyan A, Ozel A, Anarat A, Sasmaz I, Killinc Y, Gali E, Anarat R, Dikmen N: Renal function in pediatric patients with beta-thalassemia major. Pediatr Nephrol 2000;15:109–112.
  9. Sumboonnanonda A, Malasit P, Tanphaichitr V, Ong-ajyooth S, Sunthornchart S, Pattanakitsakul S, Petrarat S, Assateerawatt A, Vongjirad A: Renal tubular function in beta-thalassemia. Pediatr Nephrol 1998;12:280–283.
  10. Mohkam M, Shahin Shamsian B, Gharib A, Nariman S, Arzanian M: Early markers of renal dysfunction in patients with beta-thalassemia major. Pediatr Nephrol 2008;23:971–976.
  11. Koren G, Bentur Y, Strong D, Harvey E, Klein J, Baumal R, Spielberg S, Freedman M: Acute changes in renal function associated with deferoxamine therapy. Am J Dis Child 1989;143:1077–1080.
  12. Smolkin V, Halevy R, Levin C, Mines M, Sakran W, Ilia K, Koren A: Renal function in children with beta-thalassemia major and thalassemia intermedia. Pediatr Nephrol 2008;23:1847–1851.
  13. Nickolas TL, Barasch J, Devarajan P: Biomarkers in acute and chronic kidney disease. Curr Opin Nephrol Hypertens 2008;17:127–132.
  14. Stevens LA, Coresh J, Schmid CH, Feldman HI, Froissart M, Kusek J, Rossert J, Van Lente F, Bruce RD, Zhang YL, Greene T, Levey AS: Estimating GFR using serum cystatin C alone and in combination with serum creatinine: a pooled analysis of 3,418 individuals with CKD. Am J Kidney Dis 2008;51:395–406.
  15. Rigalleau V, Beauvieux MC, Lasseur C, Chauveau P, Raffaitin C, Perlemoine C, Barthe N, Combe C, Gin H: The combination of cystatin C and serum creatinine improves the monitoring of kidney function in patients with diabetes and chronic kidney disease. Clin Chem 2007;53:1988–1989.
  16. Dharnidharka VR, Kwon C, Stevens G: Serum cystatin C is superior to serum creatinine as a marker of kidney function: a meta analysis. Am J Kidney Dis 2002;40:221–226.
  17. Herrero-Morín JD, Málaga S, Fernández N, Rey C, Diéguez MA, Solís G, Concha A, Medina A: Cystatin C and beta-2-microglobulin: markers of glomerular filtration in critically ill children. Crit Care 2007;11:R59.
  18. Guder WG, Hofmann W: Markers for the diagnosis and monitoring of renal tubular lesions. Clin Nephrol Suppl 1992;38:S3–S7.
  19. Portman RJ, Kissane JM, Robson AM: Use of beta-2-microglobulin to diagnose tubulo-interstitial renal lesions in children. Kidney Int 1986;30:91–98.
  20. Michelakakis H, Dimitriou E, Georgakis H, Karabatsos F, Fragodimitri C, Saraphidou J, Permetis E, Karagiorga-Lagana M: Iron overload and urinary lysosomal enzyme levels in beta-thalassemia major. Eur J Pediatr 1997;156:602–604.
  21. Koliakos G, Papachristou F, Koussi A, Perifanis V, Tsatra I, Souliou E, Athanasiou M: Urine biochemical markers of early renal dysfunction are associated with iron overload in beta thalassemia. Clin Lab Haematol 2003;25:105–109.

Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: August 06, 2009
Accepted: December 22, 2009
Published online: February 24, 2010
Issue release date: April 2010

Number of Print Pages: 5
Number of Figures: 0
Number of Tables: 1

ISSN: 0001-5792 (Print)
eISSN: 1421-9662 (Online)

For additional information: https://www.karger.com/AHA


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