Publication Date:
2014-12-06
Description:
Aim: There are limited studies on renal involvement in beta-thalassemia patients. The aim of the present study was to investigate renal dysfunctions in pediatric patients with transfusion dependent beta thalassemia major (TD-βTM), using both conventional and early markers of glomerular and tubular dysfunctions and corralate findings to iron chelation therapy, deferasirox. Neutrofil-gelatinase associated lipocalin (NGAL) is an emerging biomarker in early diagnosis of acute kidney injury and also elevated urine NGAL is a good predictor of chronic kidney disease. We aimed to evaluate urine NGAL/creatinin ratio in thalassemia patients and corralate findings with normal controls. Methods: Fifty-three TD-βTM patients (aged 5-19 years) and 47 healthy controls (aged 3.5-18 years) were enrolled in this study. All patients were regularly transfused and all of them were using oral chelator; deferasirox. In addition to conventional renal biochemistries, serum cystatin C were measured with immunoturbodimetric technique. Fresh second morning urine samples collected and analysed for sodium, potassium, calcium, protein, creatinine, glucose, phosphate, uric acid, β2-microglobulin and NGAL. NGAL was measured with immunosorbent assay (ELISA). We calculated glomerular filtration rate by Schwartz formula, fractional excretion of sodium, tubular phosphorus reabsorption and uric acid excretion. Serum ferritin concentration was also measured to asses iron overload. Results: The mean age of our patients were 145±45 month, and controls were 158±140 month. A considerable number of patients demonstrated impaired renal functions. Glomerular hyperfiltration was detected in 9.5%, proteinuria in 40% , hypercalciuria in 60% increased urinary excretion of β-2 mikroglobulin in 62%, increased uric acid excretion in 58% of thalassemia patients. We detected renal tubular and glomerular dysfunctions is associated with especially pretransfusional low hemoglobine levels. We detected no relationship with deferasirox treatment doses and period with renal patologies. Mean levels of plasma cystatin C were elevated in the patient cohort compared to controls ( 0.9+0.2 and 0.78 + 0.06 mg/L, respectively, p
Print ISSN:
0006-4971
Electronic ISSN:
1528-0020
Topics:
Biology
,
Medicine
Permalink