Renal Function in β-thalassemia Major Patients Treated with Two Different Iron-chelation Regimes

Overview

Journal BMC Nephrol

Publisher Biomed Central

Specialty Nephrology

Date 2021 Dec 21

PMID 34930156

Citations 7

Authors

Osama Tanous

Yossi Azulay

Raphael Halevy

Tal Dujovny

Neta Swartz

Raul Colodner

Ariel Koren

Carina Levin

Affiliations

Soon will be listed here.

Abstract

Background: Renal injury in transfusion dependent β thalassemia patients (TDT) has been attributed to iron overload, chronic anemia and iron-chelation therapy (ICT) toxicity. We studied renal function in TDT patients treated with two different ICT regimes.

Patients And Methods: We studied 36 TDT patients: 26 received deferasirox (DFX) and 10 were treated with deferoxamine (DFO) +/- deferiprone (DFP).

Results: Increased uNAG was found in 30% of the DFX group vs. 10% of the DFO+/-DFP group, the mean uNAG level in the DFX group was significantly higher than in the DFO+/-DFP group, (P < 0.05). A moderate negative correlation was found between uNAG levels and mean serum ferritin for the prior 10 years (P = 0.03), more pronounced for the DFO+/-DFP group. Twenty nine patients had had their renal function evaluated 10 years earlier; eGFR significantly declined in patients switched to DFX (P = 0.0093) but not in patients who continued DFO+/-DFP.

Conclusions: A high prevalence of renal tubular damage was observed in our TDT patients, particularly those treated with DFX; uNAG was negatively associated with mean 10-year serum ferritin, suggesting ICT's involvement in tubular injury. A significant decline in eGFR compared to a decade earlier was observed only in patients currently treated with DFX. Strict follow-up of renal function in TDT patients is warranted.

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