Renal Dysfunction in Pediatric Patients in Iraq With β-Thalassemia Major and Intermedia

BackgroundWith optimum transfusion and chelation therapy, the survival of β-thalassemia patients and the incidence of various complications, including renal complications, have improved.ObjectivesTo investigate renal involvement in β-thalassemia patients using serum and urinary biochemical markers o...

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Published in:Curēus (Palo Alto, CA) CA), 2022-09, Vol.14 (9), p.e29183-e29183
Main Authors: Shaalan, Mohammad G, Hassan, Meaad K, Al-Shanoof, Hamid J, Al Naama, Lamia M
Format: Article
Language:English
Subjects:
Age
Anemia
Automation
Blood diseases
Blood transfusions
Chelation therapy
Creatinine
Hematology
Hematuria
Hemoglobin
Iron
Kidney diseases
Laboratories
Medical prognosis
Nephrology
Pediatrics
Potassium
Ratios
Statistical analysis
Teenagers
Uric acid
Urine
Variables
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creator Shaalan, Mohammad G
Hassan, Meaad K
Al-Shanoof, Hamid J
Al Naama, Lamia M
description BackgroundWith optimum transfusion and chelation therapy, the survival of β-thalassemia patients and the incidence of various complications, including renal complications, have improved.ObjectivesTo investigate renal involvement in β-thalassemia patients using serum and urinary biochemical markers of glomerular and tubular dysfunction.MethodsThis case-control study included 69 β-thalassemia major (β-TM) patients, 23 β-thalassemia intermedia (β-TI) patients, and 100 healthy controls, all ranging from 1 to 16 years in age. Blood urea nitrogen (BUN), serum ferritin, serum and urinary levels of creatinine (Cr), uric acid (UA), calcium (Ca), phosphorus (Ph), magnesium (Mg), sodium (Na), and potassium (K), and the urinary albumin/creatinine ratio were evaluated.ResultsThe BUN level and the urinary Na/Cr, K/Cr, Ca/Cr, Mg/Cr, Ph/Cr, albumin/Cr, and UA/Cr ratios were significantly higher in the β-thalassemia patients than in the controls. In contrast, the serum Na, K, Ca, and Mg levels were significantly lower in the patients (P0.02. At an older age, high serum ferritin levels and deferoxamine therapy were associated with significant tubular and glomerular dysfunction in β-thalassemia patients.ConclusionsPediatric patients with β-thalassemia have significantly abnormal tubular and glomerular functions, necessitating early detection and monitoring to prevent/reverse renal function deterioration.
doi_str_mv 10.7759/cureus.29183
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Blood urea nitrogen (BUN), serum ferritin, serum and urinary levels of creatinine (Cr), uric acid (UA), calcium (Ca), phosphorus (Ph), magnesium (Mg), sodium (Na), and potassium (K), and the urinary albumin/creatinine ratio were evaluated.ResultsThe BUN level and the urinary Na/Cr, K/Cr, Ca/Cr, Mg/Cr, Ph/Cr, albumin/Cr, and UA/Cr ratios were significantly higher in the β-thalassemia patients than in the controls. In contrast, the serum Na, K, Ca, and Mg levels were significantly lower in the patients (P&lt;0.05). An elevated urinary UA/Cr ratio was found in 61.9% of β-thalassemia patients, and an elevated urinary Ca/Cr, and urinary albumin/Cr ratio was found in 53.2%. An elevated Na/Cr ratio was found in 41.3%. The serum and urinary renal markers showed no significant differences between patients with β-TM and β-TI, except for microscopic hematuria, which was significantly higher in β-TI patients (34.8%) than in β-TM patients (13%), P&gt;0.02. At an older age, high serum ferritin levels and deferoxamine therapy were associated with significant tubular and glomerular dysfunction in β-thalassemia patients.ConclusionsPediatric patients with β-thalassemia have significantly abnormal tubular and glomerular functions, necessitating early detection and monitoring to prevent/reverse renal function deterioration.</description><identifier>ISSN: 2168-8184</identifier><identifier>EISSN: 2168-8184</identifier><identifier>DOI: 10.7759/cureus.29183</identifier><language>eng</language><publisher>Palo Alto: Cureus Inc</publisher><subject>Age ; Anemia ; Automation ; Blood diseases ; Blood transfusions ; Chelation therapy ; Creatinine ; Hematology ; Hematuria ; Hemoglobin ; Iron ; Kidney diseases ; Laboratories ; Medical prognosis ; Nephrology ; Pediatrics ; Potassium ; Ratios ; Statistical analysis ; Teenagers ; Uric acid ; Urine ; Variables</subject><ispartof>Curēus (Palo Alto, CA), 2022-09, Vol.14 (9), p.e29183-e29183</ispartof><rights>Copyright © 2022, Shaalan et al. This work is published under https://creativecommons.org/licenses/by/3.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Copyright © 2022, Shaalan et al. 2022 Shaalan et al.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c319t-bc8324b80503ecefa7643c4f11634bdfc5e59e79e522764fa908d62240fceddc3</citedby><cites>FETCH-LOGICAL-c319t-bc8324b80503ecefa7643c4f11634bdfc5e59e79e522764fa908d62240fceddc3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2730498624/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2730498624?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,25753,27924,27925,37012,37013,44590,53791,53793,75126</link.rule.ids></links><search><creatorcontrib>Shaalan, Mohammad G</creatorcontrib><creatorcontrib>Hassan, Meaad K</creatorcontrib><creatorcontrib>Al-Shanoof, Hamid J</creatorcontrib><creatorcontrib>Al Naama, Lamia M</creatorcontrib><title>Renal Dysfunction in Pediatric Patients in Iraq With β-Thalassemia Major and Intermedia</title><title>Curēus (Palo Alto, CA)</title><description>BackgroundWith optimum transfusion and chelation therapy, the survival of β-thalassemia patients and the incidence of various complications, including renal complications, have improved.ObjectivesTo investigate renal involvement in β-thalassemia patients using serum and urinary biochemical markers of glomerular and tubular dysfunction.MethodsThis case-control study included 69 β-thalassemia major (β-TM) patients, 23 β-thalassemia intermedia (β-TI) patients, and 100 healthy controls, all ranging from 1 to 16 years in age. Blood urea nitrogen (BUN), serum ferritin, serum and urinary levels of creatinine (Cr), uric acid (UA), calcium (Ca), phosphorus (Ph), magnesium (Mg), sodium (Na), and potassium (K), and the urinary albumin/creatinine ratio were evaluated.ResultsThe BUN level and the urinary Na/Cr, K/Cr, Ca/Cr, Mg/Cr, Ph/Cr, albumin/Cr, and UA/Cr ratios were significantly higher in the β-thalassemia patients than in the controls. In contrast, the serum Na, K, Ca, and Mg levels were significantly lower in the patients (P&lt;0.05). An elevated urinary UA/Cr ratio was found in 61.9% of β-thalassemia patients, and an elevated urinary Ca/Cr, and urinary albumin/Cr ratio was found in 53.2%. An elevated Na/Cr ratio was found in 41.3%. The serum and urinary renal markers showed no significant differences between patients with β-TM and β-TI, except for microscopic hematuria, which was significantly higher in β-TI patients (34.8%) than in β-TM patients (13%), P&gt;0.02. At an older age, high serum ferritin levels and deferoxamine therapy were associated with significant tubular and glomerular dysfunction in β-thalassemia patients.ConclusionsPediatric patients with β-thalassemia have significantly abnormal tubular and glomerular functions, necessitating early detection and monitoring to prevent/reverse renal function deterioration.</description><subject>Age</subject><subject>Anemia</subject><subject>Automation</subject><subject>Blood diseases</subject><subject>Blood transfusions</subject><subject>Chelation therapy</subject><subject>Creatinine</subject><subject>Hematology</subject><subject>Hematuria</subject><subject>Hemoglobin</subject><subject>Iron</subject><subject>Kidney diseases</subject><subject>Laboratories</subject><subject>Medical prognosis</subject><subject>Nephrology</subject><subject>Pediatrics</subject><subject>Potassium</subject><subject>Ratios</subject><subject>Statistical analysis</subject><subject>Teenagers</subject><subject>Uric acid</subject><subject>Urine</subject><subject>Variables</subject><issn>2168-8184</issn><issn>2168-8184</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><recordid>eNpdkc1Kw0AQx4MoWLQ3H2DBiwdT9yvJ7kWQ-lWoWKSit2W7mdgt6abdTYS-lg_iM5nYIupphpnf_GeYfxSdEDzIskRemMZDEwZUEsH2oh4lqYgFEXz_V34Y9UNYYIwJzijOcC96fQKnS3S9CUXjTG0rh6xDE8itrr01aKJrC64OXXXk9Rq92HqOPj_i6VyXOgRYWo0e9KLySLscjVwNftlNH0cHhS4D9HfxKHq-vZkO7-Px491oeDWODSOyjmdGMMpnAieYgYFCZylnhheEpIzP8sIkkEjIJCSUtq1CSyzylFKOCwN5bthRdLnVXTWzdrFpj_W6VCtvl9pvVKWt-ttxdq7eqnclk1RiKlqBs52Ar9YNhFotbTBQltpB1QRFM5pyQghjLXr6D11UjW__11EMcylSylvqfEsZX4Xgofg5hmDVWaW2Vqlvq9gXr1mJxw</recordid><startdate>20220915</startdate><enddate>20220915</enddate><creator>Shaalan, Mohammad G</creator><creator>Hassan, Meaad K</creator><creator>Al-Shanoof, Hamid J</creator><creator>Al Naama, Lamia M</creator><general>Cureus Inc</general><general>Cureus</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20220915</creationdate><title>Renal Dysfunction in Pediatric Patients in Iraq With β-Thalassemia Major and Intermedia</title><author>Shaalan, Mohammad G ; Hassan, Meaad K ; Al-Shanoof, Hamid J ; Al Naama, Lamia M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c319t-bc8324b80503ecefa7643c4f11634bdfc5e59e79e522764fa908d62240fceddc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Age</topic><topic>Anemia</topic><topic>Automation</topic><topic>Blood diseases</topic><topic>Blood transfusions</topic><topic>Chelation therapy</topic><topic>Creatinine</topic><topic>Hematology</topic><topic>Hematuria</topic><topic>Hemoglobin</topic><topic>Iron</topic><topic>Kidney diseases</topic><topic>Laboratories</topic><topic>Medical prognosis</topic><topic>Nephrology</topic><topic>Pediatrics</topic><topic>Potassium</topic><topic>Ratios</topic><topic>Statistical analysis</topic><topic>Teenagers</topic><topic>Uric acid</topic><topic>Urine</topic><topic>Variables</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shaalan, Mohammad G</creatorcontrib><creatorcontrib>Hassan, Meaad K</creatorcontrib><creatorcontrib>Al-Shanoof, Hamid J</creatorcontrib><creatorcontrib>Al Naama, Lamia M</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health &amp; 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Blood urea nitrogen (BUN), serum ferritin, serum and urinary levels of creatinine (Cr), uric acid (UA), calcium (Ca), phosphorus (Ph), magnesium (Mg), sodium (Na), and potassium (K), and the urinary albumin/creatinine ratio were evaluated.ResultsThe BUN level and the urinary Na/Cr, K/Cr, Ca/Cr, Mg/Cr, Ph/Cr, albumin/Cr, and UA/Cr ratios were significantly higher in the β-thalassemia patients than in the controls. In contrast, the serum Na, K, Ca, and Mg levels were significantly lower in the patients (P&lt;0.05). An elevated urinary UA/Cr ratio was found in 61.9% of β-thalassemia patients, and an elevated urinary Ca/Cr, and urinary albumin/Cr ratio was found in 53.2%. An elevated Na/Cr ratio was found in 41.3%. The serum and urinary renal markers showed no significant differences between patients with β-TM and β-TI, except for microscopic hematuria, which was significantly higher in β-TI patients (34.8%) than in β-TM patients (13%), P&gt;0.02. At an older age, high serum ferritin levels and deferoxamine therapy were associated with significant tubular and glomerular dysfunction in β-thalassemia patients.ConclusionsPediatric patients with β-thalassemia have significantly abnormal tubular and glomerular functions, necessitating early detection and monitoring to prevent/reverse renal function deterioration.</abstract><cop>Palo Alto</cop><pub>Cureus Inc</pub><doi>10.7759/cureus.29183</doi><oa>free_for_read</oa></addata></record>
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subjects Age
Anemia
Automation
Blood diseases
Blood transfusions
Chelation therapy
Creatinine
Hematology
Hematuria
Hemoglobin
Iron
Kidney diseases
Laboratories
Medical prognosis
Nephrology
Pediatrics
Potassium
Ratios
Statistical analysis
Teenagers
Uric acid
Urine
Variables
title Renal Dysfunction in Pediatric Patients in Iraq With β-Thalassemia Major and Intermedia
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