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Renal Hemosiderosis Among Iranian Transfusion Dependent Β-Thalassemia Major Patients



Hashemieh M1 ; Radfar M1 ; Azarkeivan A2 ; Taghi Hosseini Tabatabaei SM3 ; Nikbakht S4 ; Yaseri M5 ; Sheibani K6
Authors
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Authors Affiliations
  1. 1. Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  2. 2. Research Center of Iranian blood Transfusion Organization, Thalassemia Clinic, Tehran, Iran
  3. 3. Imam Hossein Medical Center, Department of Pediatric Nephrology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  4. 4. Yasuj, Iran
  5. 5. School of Public Health and Public Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
  6. 6. Basir Eye Health Center, Basir Health Clinic, Tehran, Iran

Source: International Journal of Hematology-Oncology and Stem Cell Research Published:2017

Abstract

Background:In recent years, the success in management of thalassemic patients, has allowed for some previously unrecognized complications including renal abnormalities to emerge. This prospective study aimed to investigate kidney iron overload by means of MRI T2* and also renal function based on laboratory tests for early markers of glomerular and tubular dysfunction among adult Iranian transfusion-dependent thalassemia major patients. Subjects and Methods: Two-hundred and two patients with transfusion-dependent β-thalassemia major were included in this study in Zafar Adult Thalassemia Center, Tehran, Iran. For all patients, kidney MRI T2* as well as evaluation of BUN, creatinine, uric acid, calcium, phosphorus, sodium (Na), potassium (K), total protein, albumin, cystatin C, serum ferritin β2-microglobulin, NAG (N-acetyl-beta-D-Glucosaminidase), and urine protein were performed. Results: One-hundred and fourteen female and 88 male transfusion-dependent β-thalassemia major patients with mean age of 30.1 ± 9.4 participated in the present study. We found that 77.7% of our patients had kidney hemosiderosis based on MRI T2*. Also, 67 patients (33.2%) had elevation of serum cystatin C, and 104 patients (51.5%) had reduced estimated glomerular filtration rate (e-GFR). Increased urinary excretion of NAG and hypercalciuria were found in 50% and 79.2% of participants, respectively. Conclusion: Renal hemosiderosis and asymptomatic renal dysfunction are prevalent among transfusion-dependent β-thalassemia major patients which necessitate regular screening with early markers of glomerular and tubular dysfunction. Further studies in order to investigate the correlation between renal hemosiderosis and early markers of kidney dysfunction among these patients are recommended. © 2017, Tehran University of Medical Sciences (TUMS). All rights reserved.