Frequency of Glomerular Dysfunction in Children with Beta Thalassaemia Major

Objectives: this study investigated the frequency of glomerular dysfunction in children with beta thalassaemia major (β-tm) by using different markers and correlating them with serum ferritin and iron chelation therapy. methods: the study, carried out between august 2011 and may 2012, included 100 patients with β-tm, in two groups. group ia (n = 62) received chelation therapy (deferoxamine). group ib (n = 38) received followup care at the pediatric hematology outpatient clinic, minia university children’s hospital, egypt. group ii included 50 apparently healthy controls, age- and sex-matched to group i. all patients underwent a thorough history-taking, clinical examination and laboratory investigations. results: compared to group ii, groups ia and ib had significantly higher levels of cystatin c, serum creatinine and serum ferritin, and a higher albumin/ creatinine ratio in their urine, and a significantly lower estimated glomerular filtration rate (egfr) and creatinine clearance (p <0.05). moreover, group ιa had a significantly lower egfr and creatinine clearance than group ib. cystatin c had a highly significant strong negative correlation with egfr and creatinine clearance and a significantly strong positive correlation with serum ferritin, and a higher sensitivity and specificity than serum creatinine and creatinine clearance for small changes in gfr. conclusion: β-tm patients had a high frequency of glomerular dysfunction—possibly attributable to chronic anaemia, iron overload or chelation therapy. periodic renal assessment is mandatory to detect renal complications. cystatin c is a promising marker to monitor glomerular dysfunction, having a higher sensitivity and specificity than serum creatinine and creatinine clearance for small changes in gfr.