EARLY DETECTION OF NEPHROTOXIC EFFECTS IN THALASSEMIC PATIENTS RECEIVING DESFERRIOXAMINE THERAPY

Early detection of nephrotoxic effects in thalassemic patients receiving desferrioxamine therapy. Nineteen transfusion-dependent beta-thalassemia major patients were included in the study. Six of these patients underwent chelation therapy with desferrioxamine by subcutaneous infusion (50 mg/kg/12 hr) and 13 received intravenous infusion (50 mg/kg/6 hr or 100 mg/kg/24 hr). BUN, creatinine, creatinine clearance, beta(2)-microglobulin, urinary beta(2)-microglobulin and urinary growth hormone excretion were evaluated during desferrioxamine treatment. Thirteen out of nineteen patients presented tubular damage indicated by increased excretion of urinary beta(2)-microglobulin. 85% (11 of 13) of these patients showed more serious tubular damage, as demonstrated by concurrent increased urinary growth hormone excretion. Moreover, a positive correlation between urinary growth hormone excretion and urinary beta(2)-microglobulin was observed (P < 0.05).