ESPN 51th Annual Meeting

ESPN 2018


 
DEFERASIROX- INDUCED ACUTE KIDNEY INJURY AND RENAL TUBULAR DYSFUNCTION IN CHILDREN
ASLI KAVAZ TUFAN 1 ZEYNEP CANAN ÖZDEMIR 2 NURAN ÇETIN 1 YETER DUZENLI KAR 2 ÖZCAN BÖR 2

1- ESKIŞEHIR OSMANGAZI UNIVERSITY SCHOOL OF MEDICINE, DEPARTMENT OF PEDIATRICS, DIVISION OF PEDIATRIC NEPHROLOGY, TURKEY
2- ESKIŞEHIR OSMANGAZI UNIVERSITY SCHOOL OF MEDICINE, DEPARTMENT OF PEDIATRICS, DIVISION OF PEDIATRIC HEMATOLOGY/ONCOLOGY, TURKEY
 
Introduction:

Deferasirox(DFX) is the first oral iron chelator used for the treatment of chronic iron load. Renal side effects of DFX are common and include increases in serum creatinine; however, the effect of DFX on tubule function is unclear. The aim of this study was to determine the incidence and outcome of acute kidney injury and renal tubular dysfunction in pediatric patients treated with DFX.

Material and methods:

 A retrospective cross-sectional study was performed in children treated with DFX between January 2010 and March 2018.  We examined 16 children (9 girls, mean age 162.82±58.78 months) who enrolled in a routine blood transfusion program. 

Results:

 The mean duration of disease and treatment were 125.75±68.45 (37-245) and 65.06±31.45 (13-110) months, respectively. Of the 16 patients examined, 68.7% had acute kidney injury, and 12.5% had renal tubular dysfunction. The mean time of acute kidney injury occurrence was 17.7±11 (1,5-45 ) months and renal tubular dysfunction was developed in the second and fourth months of DFX treatment. The mean dosage of DFX treatment was 30.74±9.91 (13.3-43) mg/kg per day at the time of acute kidney injury and renal tubular dysfunction occurrence. Reduction of the glomeruler filtration rate was 39.78± 14.96 % (11.3-69.1).  DFX treatment was discontinued in 2 patients with renal tubular dysfunction. The patients’ proximal tubular dysfunction is completely ameliorated in the second and fourth weeks. 

Conclusions:

Renal toxicity is a frequent adverse effect of DFX treatment. A routine renal assessment is, therefore, required to prevent acute kidney injury and renal tubular dysfunction.