Renal function in pediatric patients with beta-thalassemia major

In patients with beta -thalassemia major, the most important cause of morta lity and morbidity is organ failure due to deposits of iron.. In this study , the nature of the kidney injury and possible pathogenetic factors were in vestigated. Seventy children with beta -thalassemia major and 14 age and se x-matched healthy children were involved in the study. Blood and timed urin e samples were obtained for hematological and biochemical tests. The mean v alues of blood urea nitrogen (BUN), serum creatinine, creatinine clearance, serum sodium, urine osmolality, fractional excretion of sodium, potassium, and uric acid were not statistically different between the groups. Serum l evels of potassium, phosphorus, and uric acid and the urine volume, high ur inary protein to creatinine (U-P/Cr), urinary N-acetyl-beta -D-glucosaminid ase to creatinine (U-NAG/Cr), and urinary malondialdehyde to creatinine, (U -MDA/Cr), and the tubular phosphate reabsorption (TRP) values were statisti cally different between two groups (P<0.05). Increased serum levels of pota ssium, phosphorus, and uric acid in the patient group were attributed to th e rapid erythrocyte turnover. The presence of high U-P/Cr, U-NAG/Cr and U-M DA/Cr, ratios shows that in these patients with proximal renal tubular dama ge may be secondary to oxidative lipid peroxidation mediated by the iron ov erload.