The questioning for routine monthly monitoring of proteinuria in patients with ß-thalassemia on deferasirox chelation.
Hematology
; 22(4): 248-251, 2017 May.
Article
in En
| MEDLINE
| ID: mdl-27809710
ABSTRACT
BACKGROUND:
Iron chelation therapy is one of the mainstays of the management of the patients with ß-thalassemia (BT) major. Deferasirox is an oral active iron chelating agent. Proteinuria is one of the potential renal adverse effects of deferasirox, and monthly follow-up for proteinuria is suggested by Food and Drug Administration and European Medicine Agency.METHODS:
We aimed to investigate the necessity for monthly monitoring for proteinuria among patients with BT on deferasirox. A retrospective laboratory and clinic data review was performed for patients with BT major or intermedia who were treated with deferasirox chelation therapy. All patients were monitored for proteinuria for every 3 or 4 weeks after the initiation of deferasirox with serum creatinine and spot urine protein/creatinine ratios.RESULTS:
The median follow-up time of the 37 (36 BT major and one BT intermedia) patients was 44 months. Seven patients (18.9%) developed significant proteinuria (ratio ≥0.8). Of the 1490 measurements, 12 tests (0.8%) were proteinuric. Urine proteinuria resolved in all of the patients during the follow-up. The risk of proteinuria was higher at ages below a cut-off point of 23 years (p = 0.019). Patients, who were on deferasirox at doses above a cut-off dose of 29â mg/kg/day, were found to have higher risk of proteinuria development (p = 0.004).CONCLUSION:
Proteinuria resolves without any complication or major intervention according to our results. Potentially more risky groups (age below 23 years old and receivers above a dose of 29â mg/kg/day) might be suggested to be followed monthly, besides monitoring all of the patients.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Proteinuria
/
Triazoles
/
Benzoates
/
Beta-Thalassemia
Type of study:
Diagnostic_studies
/
Observational_studies
/
Risk_factors_studies
Limits:
Adolescent
/
Adult
/
Child
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Child, preschool
/
Female
/
Humans
/
Male
Language:
En
Journal:
Hematology
Journal subject:
HEMATOLOGIA
Year:
2017
Document type:
Article
Affiliation country:
Turkey