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Article

Earlier Detection of Glomerular Dysfunction in β-Thalassemia Major Patients

by
Waseem F. Al Tameemi
1,* and
Zainab M. J. Altawry
2
1
Department of Medicine (Hematology), College of Medicine, Al-Nahrain University, Baghdad, Iraq
2
Section of clinical Hematology, Baghdad Teaching hospital, Medical City Complex, Baghdad, Iraq
*
Author to whom correspondence should be addressed.
Thalass. Rep. 2020, 10(1), 9007; https://doi.org/10.4081/thal.2020.9007
Submission received: 2 April 2020 / Revised: 2 April 2020 / Accepted: 6 April 2020 / Published: 3 June 2020

Abstract

Chronic transfusions program in β-thalassemia patients will inevitably lead to iron overload with a significant morbidity and mortality. Glomerular filtration rate (GFR) is progressively declined in relation to iron overload as well as chronic anemia. Objective is to define levels of Cystatin C in transfusion dependent β-thalassemia major patients as a sensitive marker for detection of earlier glomerular dysfunction in addition to understand the effect of iron overload, chelating therapy and hepatitis infection. A cross sectional study conducted at Al-Basrah Hemoglobinopathy Centre for the period from September 2017 to January 2018 to enroll 75 β-thalassemia major patients. Data collected included duration of the disease, total transfusion requirement, details of chelation therapy and its therapeutic index. In addition to blood urea, serum creatinine and Cystatin C with estimated GFR (eGFR). The mean Cystatin C was 1.075 mg/L where 66.6% of patients had abnormal renal function which is higher proportion than those with renal (42.6%) detected according to serum creatinine level Cystatin C was significantly higher in patients who received desferrioxamine as compared to those received deferasirox (p = 0.007), in accordance with GFR which is significantly higher in patients receiving the latter chelation therapy (p = 0.009). A significant inverse relationship between Cystatin C, and GFR, while positive relationship between ferritin and Cystatin C (p = 0.0001, 0.001 respectively). Cyctatin C is better for detection and monitoring of glomerular dysfunction in B thalassemia major patient which is already not uncommon complications for the disease and iron chelation therapy.

Keywords: β-thalassemia major; iron overload; chelation therapy; Cystatin C; glomerular filtration rate β-thalassemia major; iron overload; chelation therapy; Cystatin C; glomerular filtration rate

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MDPI and ACS Style

Al Tameemi, W.F.; Altawry, Z.M.J. Earlier Detection of Glomerular Dysfunction in β-Thalassemia Major Patients. Thalass. Rep. 2020, 10, 9007. https://doi.org/10.4081/thal.2020.9007

AMA Style

Al Tameemi WF, Altawry ZMJ. Earlier Detection of Glomerular Dysfunction in β-Thalassemia Major Patients. Thalassemia Reports. 2020; 10(1):9007. https://doi.org/10.4081/thal.2020.9007

Chicago/Turabian Style

Al Tameemi, Waseem F., and Zainab M. J. Altawry. 2020. "Earlier Detection of Glomerular Dysfunction in β-Thalassemia Major Patients" Thalassemia Reports 10, no. 1: 9007. https://doi.org/10.4081/thal.2020.9007

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