Renal function in β-thalassemia major patients treated with two different iron-chelation regimes

BMC Nephrology

Neta Swartz¹  Raul Colodner¹  Yossi Azulay²  Ariel Koren³  Tal Dujovny³  Osama Tanous⁴  Carina Levin⁴  Raphael Halevy⁵ 

[1] Laboratory Department, Emek Medical Center, Afula, Israel;Pediatric Department B, Emek Medical Center, Afula, Israel;Pediatric Hematology Unit, Emek Medical Center, 21 Yitzhak Rabin St, Afula, Israel;Pediatric Hematology Unit, Emek Medical Center, 21 Yitzhak Rabin St, Afula, Israel;The Ruth and Bruce Rappaport Faculty of Medicine, Technion – Institute of Technology, Haifa, Israel;Pediatric Nephrology Unit, Emek Medical Center, Afula, Israel;

关键词: Thalassemia;    uNAG;    Iron chelation therapy;   

DOI  :  10.1186/s12882-021-02630-5

来源: Springer

【 摘 要 】

BackgroundRenal 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 methodsWe studied 36 TDT patients: 26 received deferasirox (DFX) and 10 were treated with deferoxamine (DFO) +/− deferiprone (DFP).ResultsIncreased 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.ConclusionsA 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.

【 授权许可】

CC BY