Arian Mahdieh, Oghazian Mohammad Bagher, Nour El Dine Mohammad Hassan, Valinejadi Ali, Badiee Zahra, Soleimani Mohsen, Sahebkar Amirhossein
Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Internal Medicine, Faculty of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran.
Curr Med Chem. 2025;32(13):2572-2597. doi: 10.2174/0109298673250805230922054406.
Early diagnosis of renal dysfunction in β-thalassemia major (β- TM) may help take specific measures to delay irreversible damage and renal failure. Therefore, the present meta-analysis aimed to compare biochemical markers of premature renal dysfunction between β-TM and healthy subjects and identify renal issues' prevalence in patients with β-TM.
We searched PubMed, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Medline, Scopus, Web of Science, ScienceDirect, ProQuest, Google Scholar, and State Inpatient Databases (SIDs) without any language constraints for all relevant articles published up to April 2019.
Out of 1458 articles published up to April 2019, 24 case-control and 22 crosssectional studies were investigated. The investigated levels of serum phosphorus, uric acid (UA), cystatin C, and ferritin were significantly different between β-TM patients and controls. The albumin/creatinine ratio (ACR), N-acetyl-β-D-glucosaminidase/creatinine (NAG/Cr) ratio, urinary and serum β2 microglobulin (β2MG), and serum ferritin levels were significantly higher in β-TM patients than in healthy individuals. However, glomerular filtration rate, creatinine clearance, and pretransfusion hemoglobin indicated a significantly lower rate. The general prevalence of renal glomerular and/or tubular defects in patients with β-TM was 50.22%.
Urinary NAG, β2MG, ACR, and Scys-C may be early markers of renal dysfunction in patients with β-thalassemia major. An observation of elevated levels of these markers despite normal levels of other markers of renal dysfunction may indicate primary, subclinical injury to the renal tubules and glomeruli.
重型β地中海贫血（β-TM）患者肾功能障碍的早期诊断有助于采取特定措施来延缓不可逆转的损伤及肾衰竭。因此，本荟萃分析旨在比较β-TM患者与健康受试者之间早期肾功能障碍的生化标志物，并确定β-TM患者中肾脏问题的患病率。
我们检索了PubMed、护理及相关健康文献累积索引（CINAHL）、医学期刊数据库（Medline）、Scopus、科学引文索引（Web of Science）、ScienceDirect、ProQuest、谷歌学术以及州住院患者数据库（SIDs），对截至2019年4月发表的所有相关文章均无语言限制。
在截至2019年4月发表的1458篇文章中，对24项病例对照研究和22项横断面研究进行了调查。β-TM患者与对照组之间血清磷、尿酸（UA）、胱抑素C和铁蛋白的检测水平存在显著差异。β-TM患者的白蛋白/肌酐比值（ACR）、N-乙酰-β-D-氨基葡萄糖苷酶/肌酐（NAG/Cr）比值、尿和血清β2微球蛋白（β2MG）以及血清铁蛋白水平显著高于健康个体。然而，肾小球滤过率、肌酐清除率和输血前血红蛋白水平则显著较低。β-TM患者肾小球和/或肾小管缺陷的总体患病率为50.22%。
尿NAG、β2MG、ACR和胱抑素C可能是重型β地中海贫血患者肾功能障碍的早期标志物。尽管其他肾功能障碍标志物水平正常，但观察到这些标志物水平升高可能表明肾小管和肾小球存在原发性亚临床损伤。
