title: Renal function in transfusion-dependent pediatric beta-thalassemia major patients.
abstract: OBJECTIVE
  In this study, the relationship between glomerular and tubular function and creatinine, glomerular filtration rate (GFR) and urine NAG in thalassemia major patients aged 7-16 years was investigated.
  
  
  METHODS
  This is a case-control study comprising 280 individuals [144 (51·4%), males; 136 (48·6%), females].
  
  
  METHODS
  Patients were divided in groups of 14 individuals and age groups of 7-16 years. Sodium excretion fraction, fraction excretion of potassium, calcium-to-creatinine and uric acid-to-creatinine ratios, and duration of specific blood transfusion were determined in all age groups receiving deferoxamine.
  
  
  RESULTS
  GFR decreased with increasing age, but the correlation was not statistically significant. There was no significant correlation between the ferritin levels and the GFR changes. The mean value of NAG activity between thalassemic patients and controls has no significant difference. The difference in mean age of the groups with high NAG activity and normal NAG activity was statistically significant. Thirty-seven patients (52·1%) in the group with normal NAG activity, and 45 patients (6·25%) in the group with NAG activity above normal were observed with uricosuric effects with no significant difference. Four patients (6·9%) in the group with normal NAG activity and six patients (7·3%) in the group with NAG activity above normal were shown to have hematuria with no significant difference. The results show that the increase in serum ferritin is significantly correlated with the increase in NAG activity (P<0·001, r = 0·2). Of patients with normal NAG activity 1 (1·7%) and with NAG activity higher than normal, 13 (15·9%) cases experienced hypercalciuria that significant difference was existing. The data also indicated that the NAG changes do not correlate with GFR changes.
  
  
  CONCLUSIONS
  The results showed that kidney dysfunction in thalassemia increases with increasing age, duration, and levels of blood transfusion and hypercalciuria. It is therefore recommended that the presence of severe renal dysfunction in thalassemic patients should be investigated using sensitive and specific tests, mainly NAG, to prevent progress towards the complications.
authors.affiliation: Department of Pharmacology and Toxicology, School of Pharmacy, Toxicology Research Center, Jundishapur University of Medical Sciences, Ahvaz, Iran. amjalali@hotmail.com
authors.forename: Amir
authors.initials: A
authors.lastname: Jalali
authors.forename: Hamid
authors.initials: H
authors.lastname: Khalilian
authors.forename: Ali
authors.initials: A
authors.lastname: Ahmadzadeh
authors.forename: Somie
authors.initials: S
authors.lastname: Sarvestani
authors.forename: Fakher
authors.initials: F
authors.lastname: Rahim
authors.forename: Khodamorad
authors.initials: K
authors.lastname: Zandian
authors.forename: Shideh
authors.initials: S
authors.lastname: Asar
mesh_terms: D000118:Acetylglucosaminidase / Q000652:urine; D000293:Adolescent; D001803:Blood Transfusion / Q000379:methods; D016022:Case-Control Studies; D002648:Child; D003404:Creatinine / Q000652:urine; D005260:Female; D006801:Humans; D007668:Kidney / Q000473:pathology / Q000503:physiopathology*; D007674:Kidney Diseases / Q000473:pathology / Q000503:physiopathology* / Q000652:urine; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D011507:Proteinuria / Q000652:urine; D017086:beta-Thalassemia / Q000473:pathology / Q000503:physiopathology* / Q000652:urine
chemical_list: D003404:Creatinine; D000118:Acetylglucosaminidase