Renal Functions in Pediatric Patients with β-Thalassemia Major: Relation to Iron Chelation Therapy | ||||
Bulletin of Egyptian Society for Physiological Sciences | ||||
Article 1, Volume 30, Issue 1, December 2010, Page 1-20 PDF (287.51 K) | ||||
Document Type: Original Article | ||||
DOI: 10.21608/besps.2010.36162 | ||||
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Authors | ||||
Enas Hamed 1; Nagla ElMelegy2 | ||||
1Department of Physiology , Faculty of Medicine, Assiut University. | ||||
2Department of Medical Biochemistry, Faculty of Medicine, Assiut University. | ||||
Abstract | ||||
Renal failure is one of the main complications in β-thalassaemia as a result of longstanding anemia, therefore the objectives of the study were: (1) To investigate glomerular and tubular functions in transfusion dependant (TD) β-thalassaemia major (βTM) pediatric patients without any occult renal diseases. 2) To correlate the findings with clinical parameters, oxidative stress status [by measuring serum total antioxidant capacity (TAC) and urinary malondialdehyde (MDA)] and desferrioxamine (DFO) chelation therapy. Patients and methods: The study included sixty-nine TD-βTM patients (45 males and 24 females). They were subdivided into those with (34 patients) and without chelation therapy (35 patients). In addition to fifteen age-, sex-, body mass index (BMI)-matched healthy subjects as a control group. From each participant blood sample was taken for determination of the serum (S) levels of creatinine (Cr), albumin, calcium (Ca), inorganic phosphorus (PO4), uric acid (UA), cystatin-C (CysC) and TAC. Also a urine sample was taken for determination of urinary (U) levels of creatinine, albumin, N-acetyl-beta-Dglucosaminidase (NAG) activity, β2-microglobulin (β2MG) and MDA. Results: The results revealed that in βTM patients the serum levels of Cr, albumin, PO4, UA, CysC, and urinary levels of NAG/Cr, β2MG/Cr, MDA/Cr, albumin/Cr were significantly higher; while serum TAC, estimated glomerular filtration rate (eGFR) were significantly lower than those of the controls. In patients with chelation therapy, serum levels of CysC, and albumin were significantly higher while, TAC was significantly lower than those without chelation therapy. Significant positive correlations were observed in TD-βTM patients between SCysC and each of Salbumin and SCr; STAC and eGFR and UNAG/Cr with each of Uβ2MG/Cr, UMDA/Cr and Ualbumin/Cr. Also, significant negative correlations were found between SCysC and eGFR; STAC and each of SCys, SCr, and Salbumin. Conclusion: The results of the present study confirm that renal tubular dysfunction exists in children with βTM which could be attributed to iron overload, oxidative stress and DFO therapy. | ||||
Keywords | ||||
β-thalassaemia major; β2-microglobulin; Cystatin-C; Desferioxamine; Nacetyl- beta-D-glucosaminidase activity; Oxidative Stress | ||||
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