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Children
Volume 8
Issue 12
10.3390/children8121104
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Systematic Review

Kidney Tubular Damage Secondary to Deferasirox: Systematic Literature Review

by
Martin Scoglio
1,
Maria Domenica Cappellini
2,
Emanuela D’Angelo
2,
Mario G. Bianchetti
1,
Sebastiano A. G. Lava
3,4,*,
Carlo Agostoni
2,5 and
Gregorio P. Milani
2,5
1
Department of Pediatrics, Pediatric Institute of Southern Switzerland, Ospedale San Giovanni, 6500 Bellinzona, Switzerland
2
Pediatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
3
Pediatric Cardiology Unit, Department of Pediatrics, Centre Hospitalier Universitaire Vaudois, and University of Lausanne, 1010 Lausanne, Switzerland
4
Heart Failure and Transplantation, Department of Pediatric Cardiology, Great Ormond Street Hospital, London WC1N 3JH, UK
5
Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20122 Milan, Italy
*
Author to whom correspondence should be addressed.
Academic Editor: Pierluigi Marzuillo
Children 2021, 8(12), 1104; https://doi.org/10.3390/children8121104
Received: 7 October 2021 / Revised: 26 November 2021 / Accepted: 26 November 2021 / Published: 1 December 2021
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Abstract

Deferasirox is a first-line therapy for iron overload that can sometimes cause kidney damage. To better define the pattern of tubular damage, a systematic literature review was conducted on the United States National Library of Medicine, Excerpta Medica, and Web of Science databases. Twenty-three reports describing 57 individual cases could be included. The majority (n = 35) of the 57 patients were ≤18 years of age and affected by thalassemia (n = 46). Abnormal urinary findings were noted in 54, electrolyte or acid–base abnormalities in 46, and acute kidney injury in 9 patients. Latent tubular damage was diagnosed in 11 (19%), overt kidney tubular damage in 37 (65%), and an acute kidney injury in the remaining nine (16%) patients. Out of the 117 acid–base and electrolyte disorders reported in 48 patients, normal-gap metabolic acidosis and hypophosphatemia were the most frequent. Further abnormalities were, in decreasing order of frequency, hypokalemia, hypouricemia, hypocalcemia, and hyponatremia. Out of the 81 abnormal urinary findings, renal glucosuria was the most frequent, followed by tubular proteinuria, total proteinuria, and aminoaciduria. In conclusion, a proximal tubulopathy pattern may be observed on treatment with deferasirox. Since deferasirox-associated kidney damage is dose-dependent, physicians should prescribe the lowest efficacious dose. View Full-Text
Keywords: deferasirox; kidney tubular damage; chelator; iron overload; transfusion deferasirox; kidney tubular damage; chelator; iron overload; transfusion
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MDPI and ACS Style

Scoglio, M.; Cappellini, M.D.; D’Angelo, E.; Bianchetti, M.G.; Lava, S.A.G.; Agostoni, C.; Milani, G.P. Kidney Tubular Damage Secondary to Deferasirox: Systematic Literature Review. Children 2021, 8, 1104. https://doi.org/10.3390/children8121104

AMA Style

Scoglio M, Cappellini MD, D’Angelo E, Bianchetti MG, Lava SAG, Agostoni C, Milani GP. Kidney Tubular Damage Secondary to Deferasirox: Systematic Literature Review. Children. 2021; 8(12):1104. https://doi.org/10.3390/children8121104

Chicago/Turabian Style

Scoglio, Martin, Maria D. Cappellini, Emanuela D’Angelo, Mario G. Bianchetti, Sebastiano A.G. Lava, Carlo Agostoni, and Gregorio P. Milani. 2021. "Kidney Tubular Damage Secondary to Deferasirox: Systematic Literature Review" Children 8, no. 12: 1104. https://doi.org/10.3390/children8121104

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