Biochemical Markers of Early Renal Dysfunction in Patients with β-thalassemia Major: A Systematic Review and Meta-analysis.

Mohsen Soleimani, Amirhossein Sahebkar, Mahdieh Arian, Mohammad Bagher Oghazian, Mohammad Hassan Nour El Dine, Ali Valinejadi, Zahra Badiee

Journal: Current medicinal chemistry 2025;32(13):2572-2597

PMID: 37921173

Full Text on Bentham Science Publishers Ltd. View on PubMed

Abstract

BACKGROUND

Early diagnosis of renal dysfunction in β-thalassemia major (β- TM) may help take specific measures to delay irreversible damage and renal failure. Therefore, the present meta-analysis aimed to compare biochemical markers of premature renal dysfunction between β-TM and healthy subjects and identify renal issues' prevalence in patients with β-TM.

METHODS

We searched PubMed, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Medline, Scopus, Web of Science, ScienceDirect, ProQuest, Google Scholar, and State Inpatient Databases (SIDs) without any language constraints for all relevant articles published up to April 2019.

RESULTS

Out of 1458 articles published up to April 2019, 24 case-control and 22 crosssectional studies were investigated. The investigated levels of serum phosphorus, uric acid (UA), cystatin C, and ferritin were significantly different between β-TM patients and controls. The albumin/creatinine ratio (ACR), N-acetyl-β-D-glucosaminidase/creatinine (NAG/Cr) ratio, urinary and serum β2 microglobulin (β2MG), and serum ferritin levels were significantly higher in β-TM patients than in healthy individuals. However, glomerular filtration rate, creatinine clearance, and pretransfusion hemoglobin indicated a significantly lower rate. The general prevalence of renal glomerular and/or tubular defects in patients with β-TM was 50.22%.

CONCLUSION

Urinary NAG, β2MG, ACR, and Scys-C may be early markers of renal dysfunction in patients with β-thalassemia major. An observation of elevated levels of these markers despite normal levels of other markers of renal dysfunction may indicate primary, subclinical injury to the renal tubules and glomeruli.

Address: Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.; Department of Internal Medicine, Faculty of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran.; Johns Hopkins University School of Medicine, Institute for Brain Protection Sciences, Johns Hopkins All Children's Hospital, Saint Petersburg, Florida, USA.; Department of Health Information Technology, Faculty of Allied Medical Sciences, Semnan University of Medical Sciences, Semnan, Iran.; Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.; Nursing Care Research Center, Faculty of Nursing and Midwifery, Semnan University of Medical Sciences, Semnan, Iran.; Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran.; Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

DOI: 10.2174/0109298673250805230922054406