TY - JOUR
T1 - Correlation of iron overload and glomerular filtration rate estimated by cystatin C in patients with β-thalassemia major
AU - Al-Khabori, Murtadha
AU - Bhandari, Sunil
AU - Al-Rasadi, Khalid
AU - Mevada, Surekha
AU - Al-Dhuhli, Hamoud
AU - Al-Kemyani, Nasser
AU - Daar, Shahina
N1 - Publisher Copyright:
© 2014 Informa Healthcare USA, Inc. All rights reserved.
PY - 2014/10/1
Y1 - 2014/10/1
N2 - Historically, renal involvement has not been a commonly recognized complication in patients with β-thalassemia major (β-TM). Herein, we studied the impact of iron overload on glomerular filtration rate (GFR) estimated by cystatin C based GFR (Cyst C eGFR). We enrolled 149 patients with β-TM in a cross sectional study in a single center in Oman. We investigated the correlation between measurement of serum ferritin and Cyst C eGFR. We used univariable linear regression to study the impact of serum ferritin on Cyst C eGFR and backwards stepwise regression to adjust for potential confounders. We included 78 males and 71 females with a mean age of 17.3±9 years (range 2.5-38.5). Seventeen patients had diabetes mellitus. Patients were taking deferiprone (DFP) and deferoxamine (DFO) (26 patients), DFP (58 patients), deferasirox (DFX) (62 patients) and one patient was taking only DFO. There was a very weak negative linear relationship between serum ferritin and Cyst C eGFR (correlation coefficient -0.25). In the univariable analyses, serum ferritin (p=0.004), diabetes status (p<0.001) and chelation therapy (p<0.001) were statistically significant. In the multivariable model, age (p=0.033), chelation with DFX (p=0.05) and diabetes status (p<0.001) were statistically significant. We found a very weak inverse linear correlation between serum ferritin and Cyst C eGFR. However, when concomitant use of chelation therapy was considered, serum ferritin did not associate with glomerular function. Prospective and larger studies are needed to confirm these findings.
AB - Historically, renal involvement has not been a commonly recognized complication in patients with β-thalassemia major (β-TM). Herein, we studied the impact of iron overload on glomerular filtration rate (GFR) estimated by cystatin C based GFR (Cyst C eGFR). We enrolled 149 patients with β-TM in a cross sectional study in a single center in Oman. We investigated the correlation between measurement of serum ferritin and Cyst C eGFR. We used univariable linear regression to study the impact of serum ferritin on Cyst C eGFR and backwards stepwise regression to adjust for potential confounders. We included 78 males and 71 females with a mean age of 17.3±9 years (range 2.5-38.5). Seventeen patients had diabetes mellitus. Patients were taking deferiprone (DFP) and deferoxamine (DFO) (26 patients), DFP (58 patients), deferasirox (DFX) (62 patients) and one patient was taking only DFO. There was a very weak negative linear relationship between serum ferritin and Cyst C eGFR (correlation coefficient -0.25). In the univariable analyses, serum ferritin (p=0.004), diabetes status (p<0.001) and chelation therapy (p<0.001) were statistically significant. In the multivariable model, age (p=0.033), chelation with DFX (p=0.05) and diabetes status (p<0.001) were statistically significant. We found a very weak inverse linear correlation between serum ferritin and Cyst C eGFR. However, when concomitant use of chelation therapy was considered, serum ferritin did not associate with glomerular function. Prospective and larger studies are needed to confirm these findings.
KW - Cystatin C
KW - Glomerular filtration rate
KW - Thalassemia
UR - http://www.scopus.com/inward/record.url?scp=84907501714&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84907501714&partnerID=8YFLogxK
U2 - 10.3109/03630269.2014.944314
DO - 10.3109/03630269.2014.944314
M3 - Article
C2 - 25074643
AN - SCOPUS:84907501714
SN - 0363-0269
VL - 38
SP - 365
EP - 368
JO - Hemoglobin
JF - Hemoglobin
IS - 5
ER -