There are limited studies on renal involvement in
beta-thalassemia, mainly involving patients on
deferoxamine, reporting both glomerular and tubular dysfunction. The aim of the present study was to investigate renal involvement in young
thalassemia patients, using both conventional and early markers of renal dysfunction, and to correlate findings to
iron chelation therapy. Forty-two patients aged 4-23 years were studied and, for analysis purposes, were divided into two groups based on
chelation therapy (group A receiving
deferasirox and group B receiving
deferoxamine and
deferiprone combination
therapy). In addition to conventional renal biochemistries,
creatinine clearance, estimated glomerular filtration rate, serum
cystatin C (Cys C), fractional excretion of
sodium, tubular
phosphorus reabsorption and urine
calcium,
protein, beta(2)-microglobulin (beta(2)-MG) and
glucose levels were measured. A considerable number of patients demonstrated impaired renal function with elevated Cys C levels (36%), glomerular dysfunction with
proteinuria (24%) and tubulopathy with
hypercalciuria (35.5%) and elevated excretion of beta(2)-MG (33.5%). Renal involvement seems to be present even in young patients with
beta-thalassemia, therefore, routine use of early markers of renal dysfunction is recommended. Further studies are needed in order to investigate the role of new
chelators in tubular function parameters.