scholarly journals Assessment of Subclinical Renal Glomerular and Tubular Dysfunction in Children with Beta Thalassemia Major

Children ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. 100
Author(s):  
Asmaa A. Mahmoud ◽  
Doaa M. Elian ◽  
Nahla MS. Abd El Hady ◽  
Heba M. Abdallah ◽  
Shimaa Abdelsattar ◽  
...  
Keyword(s):  
Cystatin C ◽  
Kidney Injury ◽  
Thalassemia Major ◽  
Beta Thalassemia ◽  
Good Survival ◽  
Control Group ◽  
Healthy Children ◽  
Serum Cystatin C ◽  
Serum Cystatin ◽  
Beta Thalassemia Major

Background: A good survival rate among patients with beta thalassemia major (beta-TM) has led to the appearance of an unrecognized renal disease. Therefore, we aimed to assess the role of serum cystatin-C as a promising marker for the detection of renal glomerular dysfunction and N-acetyl beta-D-glucosaminidase (NAG) and kidney injury molecule 1 (KIM-1) as potential markers for the detection of renal tubular injury in beta-TM children. Methods: This case-control study was implemented on 100 beta-TM children receiving regular blood transfusions and undergoing iron chelation therapy and 100 healthy children as a control group. Detailed histories of complete physical and clinical examinations were recorded. All subjected children underwent blood and urinary investigations. Results: There was a significant increase in serum cystatin-C (p < 0.001) and a significant decrease in eGFR in patients with beta-TM compared with controls (p = 0.01). There was a significant increase in urinary NAG, KIM-1, UNAG/Cr, and UKIM-1/Cr (p < 0.001) among thalassemic children, with a significant positive correlation between serum cystatin-C, NAG and KIM-1 as regards serum ferritin, creatinine, and urea among thalassemic patients. A negative correlation between serum cystatin-C and urinary markers with eGFR was noted. Conclusion: Serum cystatin-C is a good marker for detection of glomerular dysfunction. NAG and KIM-1 may have a predictive role in the detection of kidney injury in beta-TM children.

scholarly journals Cystatin C-Based Evaluation of Kidney Function of HIV-Infected Children in Benin City, Southern Nigeria

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Moses Temidayo Abiodun ◽  
Nosakhare J. Iduoriyekemwen ◽  
Phillip O. Abiodun
Keyword(s):  
Kidney Disease ◽  
Hiv Infection ◽  
Kidney Function ◽  
Cystatin C ◽  
Mean Value ◽  
Control Group ◽  
Healthy Children ◽  
Serum Cystatin C ◽  
Serum Cystatin ◽  
The Mean

Background. Human immunodeficiency virus (HIV) is now a confirmed risk factor for kidney disease with an increased burden in persons of African descent.Method. We measured the serum cystatin C levels of 205 ART-naive, HIV-infected children by an ELISA technique and compared them with the levels of apparently healthy children.Result. The mean ± SD serum cystatin C level of children with HIV infection was 1.01 ± 0.44 mg/L, significantly higher than the mean value in the control group, that is, 0.72 ± 0.20 mg/L (P=0.000). The mean ± SD cystatin C-based estimated GFR of children with HIV infection was 102.7 ± 31.0 mL/min/1.73 m2, significantly lower than 126.9 ± 28.5 mL/min/1.73 m2in the control group, (P=0.014). A significantly higher proportion of HIV-infected children compared to controls had eGFR < 90 mL/min/1.73 m2(21.5% versus 5.4%;P=0.00). The prevalence of chronic kidney disease (CKD) among the HIV-infected children was 10.7%. The cystatin C-based eGFR of the HIV-infected children ≥5 years old correlated positively with their CD4 count (r=0.23;  P=0.022).Conclusion. There is a high prevalence of CKD among HIV-infected children, requiring regular monitoring of their kidney function using a cystatin C-based method.

scholarly journals Detection of Occult Glomerular Dysfunction in Glucose Six Phosphate Dehydrogenase Deficiency Anemia

2016 ◽  
Vol 8 ◽  
pp. e2016038 ◽  
Author(s):  
Gehan Abdel Hakeem ◽  
Emad Abdel Naem ◽  
Salwa Swelam ◽  
Laila Aboul Fotoh ◽  
Abdel Azeem Al Mazary ◽  
...  
Keyword(s):  
Cystatin C ◽  
Dehydrogenase Deficiency ◽  
Kidney Injury ◽  
Deficiency Anemia ◽  
Variable Degree ◽  
Healthy Children ◽  
Serum Cystatin C ◽  
Serum Cystatin ◽  
Chronic Kidney Injury ◽  
Hemolytic Crisis

Background: Glucose six phosphate dehydrogenase deficiency (G6PD) anemia is associated with intravascular hemolysis. The freely filtered hemoglobin can damage the kidney. We aimed to assess gloumerular status in G6PD children.Methods: Sixty children were included. Thirty G6PD deficiency anemia children were enrolled during the acute hemolytic crisis and after hemolytic episode. Another thirty healthy children were included as controls. Serum cystatin C, creatinine levels and urinary albumin/creatinine (A/C) ratio were measured for glomerular filtration rate (GFR) calculation.Results:Significantly higher urinary A/C ratio and lower GFR were found during hemolysis and after the hemolytic episode compared to controls. Also, significant higher serum cystatin C, creatinine and A/C ratio and lower GFR during acute hemolytic crisis compared to the same children after the hemolytic episode subsided. Conclusions:G6PD deficiency anemia is associated with a variable degree of glomerular dysfunction during acute hemolytic episodes. This glomerular dysfunction can result in chronic subclinical or occult chronic kidney injury.

scholarly journals Role of serum cystatin-C and beta-2 microglobulin as early markers of renal dysfunction in children with beta thalassemia major

2017 ◽  
Vol Volume 10 ◽  
pp. 261-268 ◽  
Author(s):  
Ola Galal Behairy ◽  
Eman Abd Almonaem ◽  
Neveen Abed ◽  
Omima Abdel Haiea ◽  
Rasha Zakaria ◽  
...  
Keyword(s):  
Renal Dysfunction ◽  
Cystatin C ◽  
Thalassemia Major ◽  
Beta Thalassemia ◽  
Serum Cystatin C ◽  
Serum Cystatin ◽  
Early Markers ◽  
Beta 2 ◽  
Beta 2 Microglobulin

Renal Dysfunction in Pediatric Thalassemia Major Patients and Evaluation of Urine NGAL Levels in Thalassemia

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 4049-4049 ◽  
Author(s):  
Gulcihan Ozek ◽  
Özgür Carti ◽  
Erkin Serdaroglu ◽  
Serap Cuhadar ◽  
Yöntem Yaman ◽  
...  
Keyword(s):  
Uric Acid ◽  
Cystatin C ◽  
Pediatric Patients ◽  
Thalassemia Major ◽  
Beta Thalassemia ◽  
Urine Ngal ◽  
Serum Cystatin C ◽  
Serum Cystatin ◽  
Uric Acid Excretion ◽  
Early Markers

Abstract Aim: There are limited studies on renal involvement in beta-thalassemia patients. The aim of the present study was to investigate renal dysfunctions in pediatric patients with transfusion dependent beta thalassemia major (TD-βTM), using both conventional and early markers of glomerular and tubular dysfunctions and corralate findings to iron chelation therapy, deferasirox. Neutrofil-gelatinase associated lipocalin (NGAL) is an emerging biomarker in early diagnosis of acute kidney injury and also elevated urine NGAL is a good predictor of chronic kidney disease. We aimed to evaluate urine NGAL/creatinin ratio in thalassemia patients and corralate findings with normal controls. Methods: Fifty-three TD-βTM patients (aged 5-19 years) and 47 healthy controls (aged 3.5-18 years) were enrolled in this study. All patients were regularly transfused and all of them were using oral chelator; deferasirox. In addition to conventional renal biochemistries, serum cystatin C were measured with immunoturbodimetric technique. Fresh second morning urine samples collected and analysed for sodium, potassium, calcium, protein, creatinine, glucose, phosphate, uric acid, β2-microglobulin and NGAL. NGAL was measured with immunosorbent assay (ELISA). We calculated glomerular filtration rate by Schwartz formula, fractional excretion of sodium, tubular phosphorus reabsorption and uric acid excretion. Serum ferritin concentration was also measured to asses iron overload. Results: The mean age of our patients were 145±45 month, and controls were 158±140 month. A considerable number of patients demonstrated impaired renal functions. Glomerular hyperfiltration was detected in 9.5%, proteinuria in 40% , hypercalciuria in 60% increased urinary excretion of β-2 mikroglobulin in 62%, increased uric acid excretion in 58% of thalassemia patients. We detected renal tubular and glomerular dysfunctions is associated with especially pretransfusional low hemoglobine levels. We detected no relationship with deferasirox treatment doses and period with renal patologies. Mean levels of plasma cystatin C were elevated in the patient cohort compared to controls ( 0.9+0.2 and 0.78 + 0.06 mg/L, respectively, p<0.05) , Specificially ; 26/53 thalassemia patients (%49) presented with abnormally elevated serum cystatin C. Mean levels of urine NGAL/creatinin ratio was found to be elevated in patients compared to controls (85 + 88 and 31 + 38 ng/mg kreatinin, respectively, p<0.001). In thalassemia group negative significant correlation between ürine NGAL/creatinin ratio and pretransfusional hemoglobine levels was found (r=-0.35, p<0.01). And also we detected urine NGAL/creatinin ratio was corralate with other renal parametries; such as serum cystatin c/creatinin, urine β-2MG/creatinin, urine Ca/creatinin values. Conclusions: Our data confirm high frequency of glomerular and tubular dysfunctions in TD-βTM pediatric patients, and renal patologies was associated especially pretransfusional low hemoglobine levels. Therefore routine use of early markers of renal dysfunction such as urine NGAL is recommended for all patients. Disclosures No relevant conflicts of interest to declare.

scholarly journals Acute Kidney Injuries in Children with Severe Malaria

2020 ◽  
Vol 20 (4) ◽  
pp. e312-317
Author(s):  
Folake M. Afolayan ◽  
Olanrewaju T. Adedoyin ◽  
Mohammed B. Abdulkadir ◽  
Olayinka R. Ibrahim ◽  
Sikiru A. Biliaminu ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Severe Malaria ◽  
Diagnostic Criteria ◽  
Cystatin C ◽  
Filtration Rate ◽  
Kidney Injury ◽  
Serum Cystatin C ◽  
Serum Cystatin

Objectives: Serum creatinine levels are often used to diagnose acute kidney injury (AKI), but may not necessarily accurately reflect changes in glomerular filtration rate (GFR). This study aimed to compare the prevalence of AKI in children with severe malaria using diagnostic criteria based on creatinine values in contrast to cystatin C. Methods: This prospective cross-sectional study was performed between June 2016 and May 2017 at the University of Ilorin Teaching Hospital, Ilorin, Nigeria. A total of 170 children aged 0.5–14 years old with severe malaria were included. Serum cystatin C levels were determined using a particle-enhanced immunoturbidmetric assay method, while creatinine levels were measured using the Jaffe reaction. Renal function assessed using cystatin C-derived estimated GFR (eGFR) was compared to that measured using three sets of criteria based on creatinine values including the Kidney Disease: Improved Global Outcomes (KDIGO) and World Health Organization (WHO) criteria as well as an absolute creatinine cut-off value of >1.5 mg/dL. Results: Mean serum cystatin C and creatinine levels were 1.77 ± 1.37 mg/L and 1.23 ± 1.80 mg/dL, respectively (P = 0.002). According to the KDIGO, WHO and absolute creatinine criteria, the frequency of AKI was 32.4%, 7.6% and 16.5%, respectively. In contrast, the incidence of AKI based on cystatin C-derived eGFR was 51.8%. Overall, the rate of detection of AKI was significantly higher using cystatin C compared to the KDIGO, WHO and absolute creatinine criteria (P = 0.003, <0.001 and <0.001, respectively). Conclusion: Diagnostic criteria for AKI based on creatinine values may not indicate the actual burden of disease in children with severe malaria. Keywords: Biomarkers; Acute Kidney Injury; Renal Failure; Glomerular Filtration Rate; Cystatin C; Creatinine; Malaria; Nigeria.

scholarly journals Zinc Status in Beta-Thalassemia Major

2021 ◽  
Vol 9 (B) ◽  
pp. 149-153
Author(s):  
Khalaf Hussein Hasan ◽  
Hasan Abdulla Aswad ◽  
Aspazija Sofijanova
Keyword(s):  
Serum Ferritin ◽  
Ferritin Level ◽  
Disease Onset ◽  
Serum Zinc ◽  
Thalassemia Major ◽  
Adverse Outcomes ◽  
Beta Thalassemia ◽  
Control Group ◽  
Healthy Children ◽  
Zinc Status

BACKGROUND: Zinc is one of the most important minerals incorporated in the enzymes of the human body. Zinc may be deficient in patients with the β-thalassemia major with possible adverse outcomes. AIM: The purpose of this study was to assess the serum zinc status in β-thalassemia major patients in Duhok city. PATIENTS, MATERIAL, AND METHODS: In this case–control study, 70 children with β-thalassemia major (2–12 years) of both genders were enrolled and were matched with 70 apparently healthy children for age and sex. A venous blood sample was obtained from each child for the measurement of serum zinc and serum ferritin levels at Jin Center in Duhok City between January 1 and June 30, 2017. RESULTS: The mean serum zinc in the thalassemia patients (74.79 [±25.14] μg/dl) was significantly lower compared to the control group (93.61 [±15.12] μg/dl), (p = 0.0001). The serum zinc was not significantly different in thalassemia patients in terms of age, disease onset, gender, height, weight, body mass index, amount of blood transfusion, and type of chelation. There was a statistically significant correlation between serum zinc levels with a serum ferritin level of patients. CONCLUSION: The study showed that thalassemia patients have significantly lower serum levels of zinc with no relation to medical factors.

scholarly journals The Combination of Serum Cystatin C, Urinary Kidney Injury Molecule-1 and MELD plus Score Predicts Early Acute Kidney Injury after Liver Transplantation

2018 ◽  
Vol 23 (2) ◽  
pp. 121 ◽  
Author(s):  
Marian-Irinel Tudoroiu ◽  
Georgiana Constantin ◽  
Liliana Pâslaru ◽  
Speranţa Iacob ◽  
Cristian Gheorghe ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Acute Kidney Injury ◽  
Cystatin C ◽  
Kidney Injury ◽  
Serum Cystatin C ◽  
Serum Cystatin ◽  
Kidney Injury Molecule 1

scholarly journals Relationship between Vitamin B9 (Folic Acid), Vitamin B12 (Cobalamin), and Peripheral Neuropathy in Children with Beta-Thalassemia Major

2021 ◽  
Vol 9 (2) ◽  
Author(s):  
Uni Gamayani ◽  
Titin Junaidi ◽  
Nushrotul Lailiyya ◽  
Nur Suryawan ◽  
Nanan Sekarwana
Keyword(s):  
Folic Acid ◽  
Peripheral Neuropathy ◽  
Vitamin B12 ◽  
Thalassemia Major ◽  
Beta Thalassemia ◽  
Control Group ◽  
Case Group ◽  
Beta Thalassemia Major ◽  
Vitamin B9 ◽  
Significant Difference

Vitamin B9 (folic acid) and B12 (cobalamin) are essential vitamins that play roles in the process of hematopoiesis and maintaining the function of peripheral nerves. Therefore, these deficiencies may create a risk for peripheral neuropathy in beta-thalassemia major patients. The purpose of this study is to determine the relationship between vitamin B9 level, vitamin B12 level, and peripheral neuropathy in beta-thalassemia major children. It was an observational analytical study with a case-control design has been conducted at Dr. Hasan Sadikin General Hospital Bandung, Indonesia, in May–July 2019. There were 47 beta-thalassemia major children with peripheral neuropathy (case) and 41 healthy children (control). All subjects completed a general demographic questionnaire, underwent neurological examination, and were tested for vitamin B9 and B12 serum levels. Data were then analyzed using the unpaired t test to compare the vitamin levels between both groups and Spearman’s rank correlation test to investigate the correlation between vitamin levels and the number of affected nerves in the case group. Comparison of folic acid levels in the case group (21.52±6.22 ng/mL) and the control group (23.81±7.51 ng/mL) showed no significant difference (p=0.19). In contrast, cobalamin in the case group (288.57±168.61 ng/mL) and the control group (385.95±197.48 ng/mL) showed a significant difference (p=0.01). In addition, there was a moderate correlation (p=0.004, r=0.41) between folic acid level and the number of motoric nerves affected in the case group. In conclusion, cobalamin level correlates with peripheral neuropathy in beta-thalassemia major patients, and folic acid level correlates with the number of affected nerves, especially motoric nerves. HUBUNGAN ANTARA VITAMIN B9 (ASAM FOLAT), VITAMIN B12 (KOBALAMIN), DAN NEUROPATI PERIFER PADA ANAK DENGAN TALASEMIA BETA MAYORVitamin B9 (asam folat) dan B12 (kobalamin) merupakan vitamin esensial yang berperan dalam proses hematopoiesis dan menjaga fungsi saraf tepi. Defisiensi vitamin ini dapat menimbulkan risiko neuropati perifer pada pasien talasemia beta mayor. Tujuan penelitian ini mengetahui hubungan antara kadar vitamin B9, vitamin B12, dan neuropati perifer pada anak talasemia beta mayor. Metode penelitian ini adalah analitik observasional dengan rancangan studi kasus kontrol yang dilakukan di RSUP Dr. Hasan Sadikin Bandung, Indonesia pada Mei–Juli 2019. Terdapat 47 anak talasemia beta mayor dengan neuropati perifer (kelompok kasus) dan 41 anak sehat (kelompok kontrol). Seluruh subjek penelitian mengisi kuesioner demografi umum, menjalani pemeriksaan fisis neurologis, serta dilakukan tes kadar vitamin B9 dan B12 serum. Uji t test tidak berpasangan digunakan untuk membandingkan kadar vitamin pada kedua kelompok dan uji korelasi Spearman untuk membandingkan kadar kedua vitamin tersebut dengan jumlah saraf yang terkena pada kelompok kasus. Perbandingan kadar asam folat kelompok kasus (21,52±6,22 ng/mL) dan kelompok kontrol (23,81±7,51 ng/mL) menunjukkan perbedaan yang tidak bermakna (p=0,19), sedangkan perbandingan kadar kobalamin kelompok kasus (288,57±168,61 ng/mL) dan kelompok kontrol (385,95±197,48 ng/mL) menunjukkan perbedaan yang bermakna (p=0,01). Selain itu, terdapat korelasi sedang (p=0,004; r=0,41) antara kadar asam folat dam jumlah saraf motorik yang terkena pada kelompok kasus. Kesimpulan, kadar kobalamin berhubungan dengan neuropati perifer pada penderita talasemia beta mayor dan kadar asam folat berhubungan dengan jumlah saraf yang terkena, terutama saraf motorik.

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