Indicators of Renal Glomerular and Tubular Functions in Patients with Beta-Thalassaemia Major A cross sectional study at the Royal Hospital, Oman
Journal Title: Sultan Qaboos University Medical Journal - Year 2011, Vol 11, Issue 1
Abstract
Objectives: Tere are limited data concerning the assessment of renal function in beta-thalassaemia major, with no study of such involvement in Omani patients. Te objective of this study was to establish the pattern of renal glomerular and tubular function using traditional and specifc laboratory tests in patients with beta-thalassaemia major. Methods: Tis cross-sectional study, from January–July 2008, included 30 patients of the Talassaemia Clinic at the Royal Hospital, Oman, with transfusion-dependent homozygous beta-thalassaemia major. Tey included 15 males and 15 females, aged 16-32 years with mean ± standard deviation of 21.23 ± 3.42 years. Te medical records were reviewed and renal function states assessed as follows: serum creatinine, estimated glomerular fltration rate (eGFR); urea; phosphate, fractional excretion of fltered sodium (FENa); urine albumin: creatinine index; urine ß2-microglobulin:creatinine index; tubular reabsorption of phosphate (TRP), and tubular maximum phosphate reabsorption (TmP)/GFR. Results: All patients had eGFR >90 ml/min/1.73m2; serum creatinine <90 µmol/L; serum urea <6.0 mmol/L, and urine albumin:creatinine <2.5 mg/mmol. Only 2 (6.7%) patients had FENa >1% and 3 (10.0%) patients had urine ß2-microglobulin: creatinine >22 µg/mmol. All patients had TRP >0.85, of whom seven (23.3%) patients had values within the range of 0.85-0.95 and 23 (76.7%) had values >0.95. Also, all patients had TmP/GFR >1.0 mmol/L, of whom only one (3.3%) patient had TmP/GFR of 1.0–1.5, and 29 (96.7%) patients had TmP/GFR >1.5 mmol/L. Finally, 24 (80%) patients had serum phosphate >1.4 mmol/L. Linear regression revealed a highly signifcant correlation between serum phosphate and TmP/GFR (r = 0.904, P < 0.001). Conclusion: Renal function, glomerular and tubular, appears to be well preserved in beta-thalassaemia major. Almost all renal function indicators were within the recommended ranges. Raised TmP/GFR and TRP were noted in the majority of patients, reflecting an up-trend in serum phosphate and therefore increasing renal phosphate reabsorption.
Authors and Affiliations
Waad-Allah S Mula-Abed| Departments of Chemical Pathology, and Haematology, Directorate of Laboratory Medicine and Pathology, Royal Hospital, Muscat, Oman, Huda S Al-Hashmi| Departments of Chemical Pathology, and Haematology, Directorate of Laboratory Medicine and Pathology, Royal Hospital, Muscat, Oman, Muhanna N Al-Muslahi| Haematology, Directorate of Laboratory Medicine and Pathology, Royal Hospital, Muscat, Oman
Keywords
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