title: A prospective study of tubular dysfunction in pediatric patients with Beta thalassemia major receiving deferasirox.
abstract: BACKGROUND
  Beta thalassemia major is a lifelong transfusion-dependent disorder. Transfusion-dependent thalassemia patients are prone to develop renal dysfunction due to iron overload, chronic anemia, and/or chelation therapy.
  
  
  METHODS
  In this prospective study, thalassemia patients who fitted inclusion and exclusion criteria received Deferasirox 20 mg/kg/day. A complete biochemistry analysis of serum and 24-hour-urine specimens was performed before and after treatment. Estimated glomerular filtration rate (eGFR), Fractional excretion of sodium (FENA), potassium (FEK), uric acid (FEUA), and the maximum ratio of tubular reabsorption of phosphorus to eGFR (TmP/GFR) at baseline and after treatment was calculated and compared.
  
  
  RESULTS
  A total of 30 patients with mean age of 4.9 ± 3.2 years were recruited. The mean serum creatinine increased significantly after 6 months of treatment (0.54 ± 0.08 vs. 0.67 ± 0.16, P < .001) while eGFR was decreased (104.36 ± 19.62 vs. 86.00 ± 16.92, P < .001). Mean potassium level in serum was increased after treatment, while serum calcium, magnesium, and uric acid levels decreased significantly (P > .05). A significant increase was confirmed for mean urinary β2-microglobulin (β2-MG), protein, uric acid, calcium, and magnesium (P > .05).
  
  
  CONCLUSIONS
  Our findings highlighted tubular nephropathy induced by Deferasirox in patients with beta thalassemia, and confirmed the necessity for diligent monitoring of renal function in thalassemia patients receiving Deferasirox.
authors.affiliation: Ali Ebn-e Abitaleb Hospital, Children and Adolescent Health Research Center, Zahedan University of Medical Sciences , Zahedan , Iran.
authors.forename: Majid
authors.initials: M
authors.lastname: Naderi
authors.forename: Simin
authors.initials: S
authors.lastname: Sadeghi-Bojd
authors.forename: Ali Kord
authors.initials: AK
authors.lastname: Valeshabad
authors.forename: Alireza
authors.initials: A
authors.lastname: Jahantigh
authors.forename: Shaban
authors.initials: S
authors.lastname: Alizadeh
authors.forename: Akbar
authors.initials: A
authors.lastname: Dorgalaleh
authors.forename: Shadi
authors.initials: S
authors.lastname: Tabibian
authors.forename: Taregh
authors.initials: T
authors.lastname: Bamedi
mesh_terms: D000293:Adolescent; D001565:Benzoates / Q000008:administration & dosage / Q000009:adverse effects*; D001803:Blood Transfusion; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000097:blood / Q000652:urine; D000077588:Deferasirox; D005260:Female; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006801:Humans; D007502:Iron Chelating Agents / Q000008:administration & dosage / Q000009:adverse effects*; D019190:Iron Overload / Q000097:blood / Q000188:drug therapy* / Q000209:etiology / Q000652:urine; D007674:Kidney Diseases / Q000097:blood / Q000139:chemically induced* / Q000503:physiopathology / Q000652:urine; D008297:Male; D008670:Metals / Q000097:blood / Q000652:urine; D011446:Prospective Studies; D014230:Triazoles / Q000008:administration & dosage / Q000009:adverse effects*; D017086:beta-Thalassemia / Q000097:blood / Q000503:physiopathology / Q000628:therapy* / Q000652:urine
chemical_list: D001565:Benzoates; D007502:Iron Chelating Agents; D008670:Metals; D014230:Triazoles; D003404:Creatinine; D000077588:Deferasirox