Cystatin C as an Early Marker of Glomerular Dysfunction in Children with Beta Thalassemia Major | ||
| Bulletin of Egyptian Society for Physiological Sciences | ||
| Article 19, Volume 32, Issue 2, December 2012, Pages 265-278 PDF (239.52 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/besps.2012.35922 | ||
| Authors | ||
| Ahmed Mahmoud* 1; Basma Ali2 | ||
| 1Biochemistry Department, Faculty of Medicine, Minia University | ||
| 2Pediatric Department, Faculty of Medicine, Minia University | ||
| Abstract | ||
| Background and aim of work: Reports investigating renal dysfunction in beta thalassemia major (β-TM) patients have been limited in number, mainly studying adult patients. Additionally, most of them had not assessed early markers of glomerular dysfunction such as cystatin C. Early identification of patients at high risk is of great importance as it may allow specific measures to be taken to delay renal impairment. The present work aimed to estimate the frequency of glomerular dysfunction in children with β-TM by using different markers and to correlate these markers to serum ferritin and iron chelation therapy. Patients and Methods: The study included one hundred patients with β-TM (Group Ι) which was subdivided into; groups: I-a included 62 patients (62%) with iron chelation therapy (deferoxamine) and group I-b included 38 patients (38%) without iron chelation therapy and Group II (control group) included fifty apparently healthy volunteers age and sex matched to the diseased groups. Members of the two groups were subjected to; history taking, clinical examination and laboratory investigations including determination of: Serum ferritin, albumin/creatinine ratio in urine, eGFR by both Schwartz formula and creatinine clearance; blood urea and serum creatinine and finally serum cystatin C. Results: Group I showed significant higher levels of Cystatin C, serum creatinine, serum ferritin, albumin /creatinine ratio in urine than group II. Furthermore, they had significantly lower eGFR and creatinine clearance than group II (p<0.05). Moreover, group Ι-a had significant lower eGFR and creatinine clearance than group I-b. Also, cystatin C had highly significant strong negative correlation with eGFR and creatinine clearance and significant strong positive correlation with serum ferritin. Finally, cystatin C had higher sensitivity and specificity than serum creatinine and creatinine clearance for small changes in GFR. Conclusion: Glomerular dysfunction in β-TM is not a rare complication so, the use of early markers such as cystatin C is useful for the early detection of small changes in GFR. Periodic renal assessment of those patients is mandatory where many of them may had hidden renal affection | ||
| Keywords | ||
| Glomerular dysfunction; β-Thalassemia; Cystatin C | ||
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