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Review
. 2022 Nov 28:13:725-738.
doi: 10.2147/JBM.S387416. eCollection 2022.

Markers of Renal Complications in Beta Thalassemia Patients with Iron Overload Receiving Chelation Agent Therapy: A Systematic Review

Pradana Zaky Romadhon  1   2 , Ami Ashariati  3 , Siprianus Ugroseno Yudho Bintoro  3 , Mochammad Thaha  2 , Satriyo Dwi Suryantoro  2 , Choirina Windradi  2 , Bagus Aulia Mahdi  3 , Dwiki Novendrianto  3 , Krisnina Nurul Widiyastuti  3 , Okla Sekar Martani  3 , Etha Dini Widiasi  3 , Esthiningrum Dewi Agustin  3 , Emil Prabowo  4 , Yasjudan Rastrama Putra  5 , Harik Firman Thahadian  5 , Imam Manggalya Adhikara  5 , Dwita Dyah Adyarini  5 , Kartika Prahasanti  6 , Aditea Etnawati Putri  7 , Narazah Mohd Yusoff  8
Affiliations
Review

Markers of Renal Complications in Beta Thalassemia Patients with Iron Overload Receiving Chelation Agent Therapy: A Systematic Review

Pradana Zaky Romadhon et al. J Blood Med. .

Abstract

Objective: The emerging renal complications in beta-thalassemia patients have raised the global exchange of views. Despite better survival due to blood transfusion and iron chelation therapy, the previously unrecognized renal complication remain a burden of disease affecting this population -the primary concern on how iron overload and chelation therapy correlated with renal impairment is still controversial. Early detection and diagnosis is crucial in preventing further kidney damage. Therefore, a systematic review was performed to identify markers of kidney complications in beta thalassemia patients with iron overload receiving chelation therapy.

Methods: Searches of PubMed, Scopus, Science Direct, and Web of Science were conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) to identify studies of literature reporting renal outcome in β-TM patients with iron overload and receiving chelation therapy. The eligible 17 studies were obtained.

Results: uNGAL/NGAL, uNAG/NAG, uKIM-1 are markers that can be used as predictor of renal tubular damage in early renal complications, while Cystatin C and uβ2MG showed further damage at the glomerular level.

Discussion and conclusion: The renal complication in beta-thalassemia patients with iron overload receiving chelating agent therapy may progress to kidney disease. Early detection using accurate biological markers is a substantial issue that deserves further evaluation to determine prevention and management.

Keywords: chelating agent; health; iron overload; kidney; thalassemia.

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Conflict of interest statement

The authors report no financial or other conflicts of interest in this review article.

Figures

Figure 1
Figure 1
PRISMA flow chart.
See this image and copyright information in PMC

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