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Pradana Zaky Romadhon,1,2 Ami Ashariati,3 Siprianus Ugroseno Yudho Bintoro,3 Mochammad Thaha,2 Satriyo Dwi Suryantoro,2 Choirina Windradi,2 Bagus Aulia Mahdi,3 Dwiki Novendrianto,3 Krisnina Nurul Widiyastuti,3 Okla Sekar Martani,3 Etha Dini Widiasi,3 Esthiningrum Dewi Agustin,3 Emil Prabowo,4 Yasjudan Rastrama Putra,5 Harik Firman Thahadian,5 Imam Manggalya Adhikara,5 Dwita Dyah Adyarini,5 Kartika Prahasanti,6 Aditea Etnawati Putri,7 Narazah Mohd Yusoff8 1Doctoral Program of Medical Science, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia; 2Department of Internal Medicine, Universitas Airlangga Hospital, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia; 3Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia; 4Department of Cardiology and Vascular Medicine, Universitas Airlangga, Surabaya, Indonesia; 5Department of Internal Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia; 6Faculty of Medicine, Universitas Muhammadiyah Surabaya, Surabaya, Indonesia; 7Department of Clinical Pathology, Universitas Airlangga Hospital, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia; 8Advanced Medical and Dental Institute, Universiti Sains Malaysia (USM), Kepala Batas, Penang, MalaysiaCorrespondence: Ami Ashariati, Department of Internal Medicine, Universitas Airlangga Hospital, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia, Tel +62 811-328-104, Email amiashariati@yahoo.comObjective: The emerging renal complications in beta-thalassemia patients have raised the global exchange of views. Despite better survival due to blood transfusion and iron chelation therapy, the previously unrecognized renal complication remain a burden of disease affecting this population âthe primary concern on how iron overload and chelation therapy correlated with renal impairment is still controversial. Early detection and diagnosis is crucial in preventing further kidney damage. Therefore, a systematic review was performed to identify markers of kidney complications in beta thalassemia patients with iron overload receiving chelation therapy.Methods: Searches of PubMed, Scopus, Science Direct, and Web of Science were conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) to identify studies of literature reporting renal outcome in β-TM patients with iron overload and receiving chelation therapy. The eligible 17 studies were obtained.Results: uNGAL/NGAL, uNAG/NAG, uKIM-1 are markers that can be used as predictor of renal tubular damage in early renal complications, while Cystatin C and uβ 2MG showed further damage at the glomerular level.Discussion and Conclusion: The renal complication in beta-thalassemia patients with iron overload receiving chelating agent therapy may progress to kidney disease. Early detection using accurate biological markers is a substantial issue that deserves further evaluation to determine prevention and management.Keywords: thalassemia, iron overload, chelating agent, kidney, health |
