Contributions
Abstract: PB2495
Type: Publication Only
Background
Thalassemia is a hereditary hemolytic anemia resulting from defects in globin chains. Transfusion-dependent thalassemia patients are prone to develop renal dysfunction due to iron overload, chronic anemia, and/or chelation therapy.
Aims
The aim of this study was to analyze renal tubular and glomerular function in patients with beta thalasemia major (β-TM).
Methods
Thirty-eight transfusion dependant (β-TM) patients were recruited. Patients were divided into three groups based on serum ferritin levels. Glomerular functions [serum urea, creatinine, cystatin-c, estimated glomerular filtration rate (eGFR) and urinary protein excretion] and tubular functions [serum electrolytes, fractional sodium excretion (FeNa), fractional potassium excretion (FeK), tubular phosphorus reabsorption (TPR), urinary calcium excretion] were assesed in all patients.
Results
In all patients serum urea, creatinine and electrolytes were normal. Cystatin-c was increased in 5.3% of patients, GFR was increased in 28.9% and decreased in 18.4% of patients. Proteinuria (4-40 mg/m2/h) was detected in 36.8%. Protein/creatinine ratio was over 0.2 in 50% of patients. Microalbuminuria (30-300mg/day) was detected in 10.5% of the patients, albumin/creatinine ratio was above 30 mg /gr 18.4% of patients. Calcium excretion over 4mg/kg/day was found in 42.1%, and high calcium/creatinine ratio in 28.9% of the patients. FeNa was detected in 18.4% over 1%, while TPR was found to be decreased in 7.8%. Between β-TM patient groups with ferritin levels below 1000 ng/ml, between 1000-2000 ng/ml, above 2000 ng/ml, glomerular and tubular functions were not significantly different. Also there was no correlation between kidney function tests and ferritin. GFR was found to be significantly lower in patients aged 18 years and older, than patients aged 10-18 years and under 10 years according to age specific references. Creatinine was significantly lower and protein/creatinine ratio was significantly higher in patients younger than 10 years of age.
Conclusion
Different levels of renal tubular and / or glomerular dysfunction were encountered in this study. Findings suggest that renal injury is associated with increased age. In our study, serum ferritin did not correlated with renal tubular and glomerular functions.
Session topic: 28. Thalassemias
Keyword(s): Ferritin, Renal impairment, Thalassemia
Abstract: PB2495
Type: Publication Only
Background
Thalassemia is a hereditary hemolytic anemia resulting from defects in globin chains. Transfusion-dependent thalassemia patients are prone to develop renal dysfunction due to iron overload, chronic anemia, and/or chelation therapy.
Aims
The aim of this study was to analyze renal tubular and glomerular function in patients with beta thalasemia major (β-TM).
Methods
Thirty-eight transfusion dependant (β-TM) patients were recruited. Patients were divided into three groups based on serum ferritin levels. Glomerular functions [serum urea, creatinine, cystatin-c, estimated glomerular filtration rate (eGFR) and urinary protein excretion] and tubular functions [serum electrolytes, fractional sodium excretion (FeNa), fractional potassium excretion (FeK), tubular phosphorus reabsorption (TPR), urinary calcium excretion] were assesed in all patients.
Results
In all patients serum urea, creatinine and electrolytes were normal. Cystatin-c was increased in 5.3% of patients, GFR was increased in 28.9% and decreased in 18.4% of patients. Proteinuria (4-40 mg/m2/h) was detected in 36.8%. Protein/creatinine ratio was over 0.2 in 50% of patients. Microalbuminuria (30-300mg/day) was detected in 10.5% of the patients, albumin/creatinine ratio was above 30 mg /gr 18.4% of patients. Calcium excretion over 4mg/kg/day was found in 42.1%, and high calcium/creatinine ratio in 28.9% of the patients. FeNa was detected in 18.4% over 1%, while TPR was found to be decreased in 7.8%. Between β-TM patient groups with ferritin levels below 1000 ng/ml, between 1000-2000 ng/ml, above 2000 ng/ml, glomerular and tubular functions were not significantly different. Also there was no correlation between kidney function tests and ferritin. GFR was found to be significantly lower in patients aged 18 years and older, than patients aged 10-18 years and under 10 years according to age specific references. Creatinine was significantly lower and protein/creatinine ratio was significantly higher in patients younger than 10 years of age.
Conclusion
Different levels of renal tubular and / or glomerular dysfunction were encountered in this study. Findings suggest that renal injury is associated with increased age. In our study, serum ferritin did not correlated with renal tubular and glomerular functions.
Session topic: 28. Thalassemias
Keyword(s): Ferritin, Renal impairment, Thalassemia