comparative evaluation of renal findings in beta-thalassemia major and intermedia

Thalassemia is a systematic disease in which the renal involvement has not yet been scrupulously studied. In a cross-sectional study, the renal findings of 50 cases of thalassemia intermedia (group 1) were compared to 58 patients with thalassemia major (group 2). Blood urea nitrogen, serum creatinine, uric acid, calcium, phosphorus, urinalysis, and ultrasonographical findings were evaluated. Mean age was 18 ± 3.0 in group 1 and 17 ± 3.5 years in group 2. The mean of serum ferritin levels was 871 ± 81.8 ng/ml in group 1 vs. 3503 ± 201 ng/ml in thalassemia major (p < 0.05). Ninety-two percent of the patients in group 1 were on hydroxyurea at the time of evaluation. Serum uric acid was significantly higher in group 1 than group 2 patients (5.74 ± 2.95 vs. 4.12 ± 0.9 mg/dl, p < 0.05). Microscopic hematuria (red blood cell in high power field of urine microscopy > 5) was observed among 19 children (17.6%); 17 of them were in group 1. In contrast, children with thalassemia major had significantly higher serum creatinine (0.89 ± 0.18 vs. 0.59 ± 0.37 mg/dl, p < 0.05) and blood urea nitrogen values (12.14 ± 5.58 vs. 13.85 ± 3.54 mg/dl, p < 0.05). We conclude that significant renal involvement is not a frequent complication in children and young adults suffering from thalassemia. Hyperuricemia and microscopic hematuria are more common in thalassemia intermedia than thalassemia major. Microscopic hematuria in thalassemia intermedia might be related to either hypercalciuria or hyperuricosuria.