Pediatric Nephrology

, 23:1847 | Cite as

Renal function in children with β-thalassemia major and thalassemia intermedia

  • Vladislav Smolkin
  • Raphael Halevy
  • Carina Levin
  • Miguel Mines
  • Waheeb Sakran
  • Katzap Ilia
  • Ariel Koren
Original Article

Abstract

In β-thalassemia, profound anemia and severe hemosiderosis cause functional and physiological abnormalities in various organ systems. In recent years, there have been few published studies demonstrating proteinuria, aminoaciduria, low urine osmolality, and excess secretion of the tubular damage markers, such as urinary N-acetyl-D-glucosaminidase (UNAG) and β2 microglobulin, in patients with thalassemia. The object of this study was to analyze renal tubular and glomerular function in pediatric patients with β-thalassemia and to correlate the renal findings to iron overload. Thirty-seven patients with β-thalassemia major and 11 with thalassemia intermedia were studied. Twelve children without iron metabolism disorders or renal diseases served as a control group. No difference in blood urea nitrogen (BUN), serum creatinine, creatinine clearance, electrolytes, fractional excretion of sodium and potassium, and tubular phosphorus reabsorption was found. Serum uric acid was equal in the two groups, but its urine excretion was significantly higher in the thalassemic group. UNAG and UNAG to creatinine ratio (UNAG/CR) were elevated in all patients with thalassemia compared with the control group (p < 0.001) and were directly correlated to the amount of transfused iron but not to actual ferritin level. We found that renal tubular function is impaired in children with β- thalassemia major and intermedia. It is not known whether these functional abnormalities would have any long-term effects on the patients. Further studies are needed, and means of preventing these disturbances should be sought.

Keywords

β-thalassemia major Thalassemia intermedia Renal tubular function Urine N-acetyl-D-glucosaminidase 

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Copyright information

© IPNA 2008

Authors and Affiliations

  • Vladislav Smolkin
    • 1
    • 2
  • Raphael Halevy
    • 1
    • 2
  • Carina Levin
    • 3
  • Miguel Mines
    • 4
  • Waheeb Sakran
    • 1
    • 5
  • Katzap Ilia
    • 1
  • Ariel Koren
    • 1
    • 3
    • 5
  1. 1.Pediatric Department “B”Ha’Emek Medical CenterAfulaIsrael
  2. 2.Pediatric Nephrology UnitHa’Emek Medical CenterAfulaIsrael
  3. 3.Pediatric Hematology UnitHa’Emek Medical CenterAfulaIsrael
  4. 4.Biochemistry LaboratoryHa’Emek Medical CenterAfulaIsrael
  5. 5.Baruch Rappaport School of Medicine, TechnionIsrael Institute of TechnologyHaifaIsrael

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