Evaluation of Proteinuria in β-Thalassemia Major Patients With and Without Diabetes Mellitus Taking Deferasirox

Karimi, Mehran; Avazpour, Abbas; Haghpanah, Sezaneh; Toosi, Foroogh; Badie, Arash Davatgar

doi:10.1097/mph.0000000000000658

Cited by 4 publications

(6 citation statements)

References 14 publications

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“…On the other hand, a retrospective study of 72 patients (mean age: 20.3 ± 0.9 yrs; 36 male, 36 female) with thalassemia major or intermedia treated at Sultan Qaboos University Hospital found that the renal side effects related to deferasirox appear to be higher than those reported in published clinical trials [92]. Reassuringly, DFX proved to be safe in managing iron overload in thalassemia patients with end stage renal disease [93] or diabetes mellitus [94]. DFO chelates iron is located in plasma and ferritin by forming a metabolically inactive complex, which is renally excreted.…”

Section: The Role Of Iron Chelating Agents In Renal Diseasementioning

confidence: 97%

Beta-thalassemia: renal complications and mechanisms: a narrative review

et al. 2019

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Objectives: Beta-thalassemias are a group of recessively autosomal inherited disorders of hemoglobin synthesis, which, due to mutations of the beta-globin gene, lead to various degrees of defective beta-chain production, an imbalance in alpha/beta-globin chain synthesis, ineffective erythropoiesis, and anemia. Improved survival in thalassemic patients has led to the emergence of previously unrecognized complications, such as renal disease. Methods: A comprehensive literature review through PubMed was undertaken to summarize the published evidence on the epidemiology and pathophysiology of renal disease in thalassemia. Literature sources published in English since 1990 were searched, using the terms beta-thalassemia, renal disease. Results: Renal disease is considered to be the 4th cause of morbidity among patients with transfusion dependent thalassemia. Chronic anemia, hypoxia and iron overload are the main mechanisms implicated in development of renal injury, whereas several studies also suggested a contributive role of iron chelators. Discussion and Conclusion: Kidney disease may develop through progressive renal tubular and glomerular damage; thus, its early recognition is important in order to prevent and/or reverse deterioration. This review will provide an insight on the involved mechanisms implicated in kidney disease in thalassemic patients and will discuss the updates on diagnosis and prevention of renal complications in thalassemia.

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Section: The Role Of Iron Chelating Agents In Renal Diseasementioning

confidence: 97%

Beta-thalassemia: renal complications and mechanisms: a narrative review

et al. 2019

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“…Studies indicated that ICT did not provide substantial improvements in quality of life, but that the economic burden of long-term treatment with ICT was high. Patients also continued to experience endocrine dysfunction despite lifelong treatment with ICT [ 17 , 19 , 20 , 25 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 ].…”

Section: Discussionmentioning

confidence: 99%

Relationship between Serum Ferritin and Outcomes in β-Thalassemia: A Systematic Literature Review

Shah

Huey

Deshpande

et al. 2022

JCM

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Among the difficulties of living with β-thalassemia, patients frequently require blood transfusions and experience iron overload. As serum ferritin (SF) provides an indication of potential iron overload, we conducted a systematic literature review (SLR) to assess whether SF levels are associated with clinical and economic burden and patient-reported outcomes (PROs). The SLR was conducted on 23 April 2020 and followed by analysis of the literature. Dual-screening was performed at the title, abstract, and full-text levels using predefined inclusion and exclusion criteria. Ten studies identified by the SLR were eligible for inclusion in the analysis. Seven studies were conducted in Europe, and most were prospective or retrospective in design. The patient populations had a median age of 20.7–42.6 years, with a percentage of men of 38–80%. Sparse data were found on the correlation between SF levels and mortality, and hepatic, skeletal, and cardiac complications; however, in general, higher SF levels were associated with worsened outcomes. The bulk of the evidence reported on the significant association between higher SF levels and endocrine dysfunction in its many presentations, including a 14-fold increase in the risk of diabetes for patients with persistently elevated SF levels. No studies reporting data on PROs or economic burden were identified by the SLR. SF levels provide another option for prognostic assessment to predict a range of clinical outcomes in patients with β-thalassemia.

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“…showed that DFX (Exjade®) had no significant effects on BUN level in patients compared to the control group. [ 31 ] Karimi et al . [ 31 ] and Aftab et al .…”

Section: Discussionmentioning

confidence: 99%

“…[ 31 ] Karimi et al . [ 31 ] and Aftab et al . [ 25 ] reported that DFX is a safe and effective drug for TM patients.…”

Section: Discussionmentioning

confidence: 99%

Renal Function in Patients with Thalassemia Major Receiving Exjade® Dispersible Tablets and a New Film-coated Tablet Formulation of Deferasirox (Nanojade®)

Falahati

Ghasemi

Safari

et al. 2022

Advanced Biomedical Research

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Background: In patients with β-thalassemia major (TM), one of the long-term complications of regular blood transfusion is renal dysfunction. The purpose of the current study was to evaluate the renal function in TM patients receiving Exjade ® dispersible tablets and a new film-coated tablet formulation of deferasirox (Nanojade ® ). Materials and Methods: In this descriptive cross-sectional study, a total of 80 TM patients aged 11–48-year-old entered the study. Patients received 20–30 mg/kg/d (single dose) Exjade® (Exjade group, n = 40) and Nanojade® (Nanojade group, n = 40) orally. To evaluated renal function, serum creatinine (S Cr ), estimated glomerular filtration rate (eGFR), blood urea nitrogen (BUN), 24-h urine protein (U Pro ), U Ca /U Cr , spot U Pro /U Cr ratio, and serum ferritin were calculated at baseline and every 3 months to 9 months. Results: There was no significant difference in S Cr , BUN, eGFR, 24-h U Pro , U Pro /U Cr ratio, U Ca /U Cr ratio, and serum ferritin between groups at baseline and end of study ( P baseline > 0.05, P end of study > 0.05). There was no significant difference in proteinuria between groups at baseline and end of study ( P baseline > 0.05, P end of study > 0.05). Conclusions: The proportion of S Cr , BUN, eGFR, 24-h U Pro , U Pro /U Cr ratio, and U Ca /U Cr ratio was not significantly different in TM patients treated with Nanojade ® compared to patients’ received Exjade ® . Nanojade ® had similar effects to Exjade ® , and therefore, the use of Nanojade ® is safe in TM patients and does not seem to be associated with increased renal failure, proteinuria, and hypercalciuria.

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Evaluation of Proteinuria in β-Thalassemia Major Patients With and Without Diabetes Mellitus Taking Deferasirox

Cited by 4 publications

References 14 publications

Beta-thalassemia: renal complications and mechanisms: a narrative review

Beta-thalassemia: renal complications and mechanisms: a narrative review

Relationship between Serum Ferritin and Outcomes in β-Thalassemia: A Systematic Literature Review

Renal Function in Patients with Thalassemia Major Receiving Exjade® Dispersible Tablets and a New Film-coated Tablet Formulation of Deferasirox (Nanojade®)

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