Renal function in patients with β-thalassaemia major: A long-term follow-up study

Maria Eliana Lai, Alessandra Spiga, Stefania Vacquer, Maria Paola Carta, Claudia Corrias, Claudio Ponticelli

Research output: Contribution to journalArticlepeer-review

Abstract

Background. Little information is available about the kidney's involvement in patients with β-thalassaemia major (TM). In particular, there are no studies reporting the outcome of renal function over time. Methods. In this retrospective study, we evaluated the changes in estimated glomerular filtration rate (eGFR) in 81 adult patients with TM followed for 10 years. Only patients who had an eGFR of >90 mL/min/1.73 m2 at presentation were admitted to the study. All patients were regularly followed for at least 10 years. Results. At 10 years, 66 patients showed a mild decline in eGFR that remained, however, within a normal range (from 119.9 to 113.6 mL/min/1.73 m 2, P = 0.636). In the remaining 15 patients (18.5%), eGFR decreased to 2; P = 0.004). The repeated-measures models showed that the decline in eGFR over time was significantly higher (P = 0.0068) in patients with baseline phosphaturia >1000 mg/24 h (P = 0.0068), while eGFR tended to decline more rapidly in patients with baseline uricuria >700 mg/24 h than in those with lower uricuria (P = 0.0783). Univariate Cox's proportional regression models showed that abnormal levels of calcaemia were associated with the risk of kidney damage [hazard ratio (HR) 0.30, 95% confidence interval 0.09-0.97 for calcaemia 8.4-10.2 mg/dL versus HR not estimable for calcaemia 10.2 mg/dL]. Conclusions. In most adults with TM, the eGFR tends to remain within a normal range after 10 years. However, patients with elevated phosphaturia, elevated uricuria and/or abnormal levels of calcaemia show a significant decline in eGFR over time, suggesting that tubular damage acquired in childhood caused by either TM or its treatment may eventually result in abnormal eGFR. Further studies in a larger cohort of TM patients are needed to further elucidate the long-term impact of TM on renal function.

Original languageEnglish
Pages (from-to)3547-3551
Number of pages5
JournalNephrology Dialysis Transplantation
Volume27
Issue number9
DOIs
Publication statusPublished - Sep 2012

Keywords

  • anaemia and renal function
  • iron and renal function
  • thalassaemia and renal function
  • thalassaemia major

ASJC Scopus subject areas

  • Nephrology
  • Transplantation

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