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Abstract
Frequent blood transfusion has increased the life expectancy of patients with Ý-thalassemia major, but it causes progressive iron overload causing important oxidative damage, mostly to the heart, liver and endocrine glands. Its effect on the kidneys is less known, yet chronic anemia, iron overload, and treatment with certain iron chelators have been linked to kidney dysfunction. The main objective of this study is to investigate the presence of glomerular and/or tubular dysfunction in patients with Ý-thalassemia major, using both common and advanced indexes, and to correlate possible findings to iron chelation therapy. This case control study included 60 thalassemia major patients aged between 5 and 24 years who were regularly transfused and receiving regular chelation program and 60 apparently healthy individuals, who were age-matched, as controls. There were statistically significant differences between cases and control groups regarding hemoglobin concentration and serum ferritin (p<0.001) and non significant differences regarding blood urea, serum creatinine, sodium, potassium, magnesium, calcium and phosphorus, PH and total bicarbonate (p>0.05). Significant A/Cr ratio ( 30.8-280 mg/g) was positive in 21.7% of cases and 20% were positive for significant Ca/Cr ratio (>210 mg/g) , 38.30% were positive for serum Cystatin C and 30% were positive for urinary Ý2-MG. There was a significant correlation between both serum Cystatin C and Ý2-MG (p<0.001) with serum ferritin (p<0.05), but not with blood urea, serum creatinine or eGFR p>0.05