Mohd Zikre, Nurwahida and Muhamad, Nor A. and Eng, Caroline S. Y. and Zailanalhuddin, Nur E. and Lai, Charles D. and Foo, Jen C. and Yap, Suet L. and Ariffin, Hany and Abu Bakar, Karmila (2021) Occult kidney dysfunction in children with transfusion-dependent thalassemia. Frontiers in Pediatrics, 9. ISSN 2296-2360, DOI https://doi.org/10.3389/fped.2021.754813.
Full text not available from this repository.Abstract
Thalassemia is the commonest hemoglobinopathy in Southeast Asia. Kidney dysfunction is an underreported sequelae in children with thalassemia. We conducted a retrospective study to identify the prevalence of and predisposing factors for kidney dysfunction in children with transfusion-dependent thalassemia (TDT). Method: Abnormal kidney function was defined as children with a glomerular filtration rate (GFR) of <90 ml/min/1.73 m2 or a decline in GFR of >20 ml/min/1.73 m2 or presence of nephrotic range proteinuria within 3 years of commencing regular (every ≤6 weeks) red cell transfusion. Data analyzed were age at diagnosis of thalassemia, number of transfusion-years, iron chelation therapy, serum ferritin, and pre-transfusion hemoglobin levels. Results: Eighty-one children were studied. Mean age was 11.72 ± 5.275 years. Thirty out of 81 (37) demonstrated abnormal kidney function. Evidence of glomerular hyperfiltration was seen in 29/81 patients (25.85) at their last clinic visit. This fraction was doubled 48/81 (59.3%) when the cohort was tracked back by 3 years from the last clinic encounter. Age at diagnosis (RR, 1.157; 95% CI, 1.014–1.319; p = 0.03) and duration of receiving transfusions (RR, 0.984; 95% CI, 0.974–0.994; p = 0.001) were associated with increased risk of developing abnormal kidney function. Conclusion: Abnormal kidney function in children with TDT may be overlooked by medical personnel without active screening measures. Children receiving regular red cell transfusions require systematic surveillance to enable early detection of kidney dysfunction and timely implementation of appropriate therapeutic interventions. Copyright © 2021 Mohd Zikre, Muhamad, Eng, Zailanalhuddin, Lai, Foo, Yap, Ariffin and Abu Bakar.
| Item Type: | Article |
|---|---|
| Funders: | UNSPECIFIED |
| Uncontrolled Keywords: | Thalassemia; Nephropathy; Transfusion-dependent; Ferritin; Iron; Chelator |
| Subjects: | R Medicine |
| Divisions: | Faculty of Medicine |
| Depositing User: | Ms Zaharah Ramly |
| Date Deposited: | 22 Aug 2023 08:05 |
| Last Modified: | 22 Aug 2023 08:05 |
| URI: | http://eprints.um.edu.my/id/eprint/35728 |
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