Renal iron deposition by magnetic resonance imaging in pediatric β-thalassemia major patients: relation to renal biomarkers, total body iron and chelation therapy.

Publication date: Available online 9 April 2018
Source:European Journal of Radiology
Author(s): Mohsen Saleh ElAlfy, Nayera Hazaa El-Sherif, Fatma Soliman El-Sayed Ebeid, Eman Abdel Rahman Ismail, Khaleid Abo Elfotouh, Yasser Wagih Darwish, Ahmed S. Ibrahim, Islam Reda Farag Elghamry, Nermeen Adel Shokrey, Dunia Naser Alajeil
BackgroundThe reciprocal of multiecho gradient-echo (ME–GRE) T2* magnetic resonance imaging (MRI) R2*, rises linearly with tissue iron concentration in both heart and liver. Little is known about renal iron deposition in β-thalassemia major (β-TM).AimTo assess renal iron overload by MRI and its relation to total body iron and renal function among 50 pediatric patients with β-TM.MethodsSerum ferritin, serum cystatin C, urinary albumin creatinine ratio (UACR), and urinary β2-microglobulin (β2 M) were measured with calculation of β2 M/albumin ratio. Quantification of liver, heart and kidney iron overload was done by MRI.ResultsSerum cystatin C, UACR and urinary β2 microglobulin as well as urinary β2m/albumin were significantly higher in β-TM patients than the control group. No significant difference was found as regards renal R2* between Patients with mean serum ferritin above 2500 μg/L and those with lower serum cutoff. Renal R2* was higher in patients with poor compliance to chelation therapy and positively correlated to indirect bilirubin, LDH, cystatin C and LIC but inversely correlated to cardiac T2*.Conclusionkidney iron deposition impairs renal glomerular and tubular functions in pediatric patients with β-TM and is related to hemolysis, total body iron overload and poor compliance to chelation.



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