Occult Kidney Dysfunction in Children With Transfusion-Dependent Thalassemia.

Autor:	Mohd Zikre N; Paediatric Unit, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia., Muhamad NA; Sector for Evidence-Based Healthcare, National Institutes of Health, Ministry of Health, Kuala Lumpur, Malaysia., Eng CSY; Paediatric Unit, Hospital Tuanku Ja'afar, Seremban, Malaysia., Zailanalhuddin NE; Paediatric Unit, Hospital Tuanku Ja'afar, Seremban, Malaysia., Lai CD; Paediatric Unit, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia., Foo JC; Paediatric Unit, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia., Yap SL; Paediatric Unit, Hospital Tuanku Ja'afar, Seremban, Malaysia., Ariffin H; Paediatric Unit, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia., Abu Bakar K; Paediatric Unit, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia.
Jazyk:	angličtina
Zdroj:	Frontiers in pediatrics [Front Pediatr] 2021 Nov 22; Vol. 9, pp. 754813. Date of Electronic Publication: 2021 Nov 22 (Print Publication: 2021).
DOI:	10.3389/fped.2021.754813
Abstrakt:	Background: 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 m 2 or a decline in GFR of >20 ml/min/1.73 m 2 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. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2021 Mohd Zikre, Muhamad, Eng, Zailanalhuddin, Lai, Foo, Yap, Ariffin and Abu Bakar.)
Databáze:	MEDLINE
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