The Effect of Iron Chelators on urine Beta Microglobulin(β2M) and Serum Sodium on Patients with Thalassemia Major

Abstract

Background and Objectives Thalassemia is the most common genetic disease associated with the body's recurrent blood transfusions and iron overload. Iron chelators can reduce the adverse effects of iron overload through various mechanisms. However, concerns have recently been raised about their negative impact on renal function. The current study, therefore, examined the effect of different iron chelators on renal function in patients with thalassemia major. Subjects and Methods This cross-sectional descriptive study included primary thalassemia patients (5 - 25 years) referring to Ahwaz Thalassemia Center for regular blood transfusion and regular treatment with iron chelators. They were divided into 3 groups (deferiprone 60-80 mg/kg/d, deferasirox 15-35 mg/kg/d and deferoxamine 11-48 mg/kg/d). Blood and 24-hour urine samples were collected to determine glomerular filtration rate (GFR) and biochemical factors. Results No significant difference was observed between the studied groups in terms of GFR, urine albumin, serum creatinine, serum cystatin C, serum and urine phosphorus, and urine sodium (p > 0.05), but serum sodium and urine β2microglobulin (β2M) were significantly different between the studied groups (p < 0.05). Serum sodium was significantly higher in the deferiprone group compared to the control (P=0.004). Urine β2M was significantly higher in the deferoxamine and deferasirox groups in comparison with the control group (P=0.041, P=0.013). Finally, serum sodium was significantly higher in the deferiprone and deferasirox groups than that in the deferoxamine group (P=0.001, P=0.021). Conclusion Urine beta-2 microglobulin increased in patients receiving deferoxamine and deferasirox compared to the control group, which might indicate primary kidney damage.