Русский
Posttransfusion hemochromatosis and cardiorenal syndrome. Local register data
DOI: https://dx.doi.org/10.18565/nephrology.2023.4.21-27
Matveev M.D., Mikhailova Z.D.
City Clinical Hospital № 38, Nizhny Novgorod, Russia
Objective. Evaluation of the effect of posttransfusion hemochromatosis (HC) on renal and cardiac function.
Material and methods. The retrospective analysis included 24 patients with posttransfusion HC, of whom 20 were men (64.65±14.19 years) and 4 women (60.5±19.87 years), mean age 63.95±14.84 years. Almost half (46%) of the patients were diagnosed with myelodysplastic syndrome. Less commonly (17%) patients had acute myeloblastic leukemia. Chronic myeloproliferative disease was diagnosed in 9% of patients. All patients received blood transfusions. In all patients, clinical and basic biochemical parameters, incl. ferritin level, were monitored over time. Electrocardiography (ECG) and echocardiography (Echo-CG), abdominal an renal ultrasound examination were performed.
Results. Chronic kidney disease (CKD) was diagnosed in 41.7% of patients: stage C2 (n=2), stage C3a (n=5), stage C3b (n=1), stage C4 (n=1), stage C5 (n =1). The causes of CKD inclued hypertension, diabetes mellitus (n=5). Chronic heart failure (CHF) was diagnosed in 37.5% of patients from the sample: stage I (n=1), stage IIA (n=6), stage IIB (n=1) and stage III (n=1). The causes of CHF included hypertension, coronary artery disease. Patients were treated in accordance with current clinical guidelines. All patients were diagnosed with posttransfusion HC. Patients received deferasirox, the dose and duration of therapy were adjusted taking into account ferritin levels over time. A moderate positive correlation (r=0.581; p=0.003) between the transfusion load and ferritin level, as well as a moderate positive correlation (r=0.416; p=0.043) between the ferritin and creatinine levels were found. In the analyzed sample, 8 patients died in the hospital. The cause of death was progression of the underlying disease with the development of multiple organ failure syndrome.
Conclusion. In the presence of a high transfusion load, the blood ferritin level increases. The higher the ferritin level, the higher the creatinine level. There is a correlation between the presence of CHF and CKD.
Material and methods. The retrospective analysis included 24 patients with posttransfusion HC, of whom 20 were men (64.65±14.19 years) and 4 women (60.5±19.87 years), mean age 63.95±14.84 years. Almost half (46%) of the patients were diagnosed with myelodysplastic syndrome. Less commonly (17%) patients had acute myeloblastic leukemia. Chronic myeloproliferative disease was diagnosed in 9% of patients. All patients received blood transfusions. In all patients, clinical and basic biochemical parameters, incl. ferritin level, were monitored over time. Electrocardiography (ECG) and echocardiography (Echo-CG), abdominal an renal ultrasound examination were performed.
Results. Chronic kidney disease (CKD) was diagnosed in 41.7% of patients: stage C2 (n=2), stage C3a (n=5), stage C3b (n=1), stage C4 (n=1), stage C5 (n =1). The causes of CKD inclued hypertension, diabetes mellitus (n=5). Chronic heart failure (CHF) was diagnosed in 37.5% of patients from the sample: stage I (n=1), stage IIA (n=6), stage IIB (n=1) and stage III (n=1). The causes of CHF included hypertension, coronary artery disease. Patients were treated in accordance with current clinical guidelines. All patients were diagnosed with posttransfusion HC. Patients received deferasirox, the dose and duration of therapy were adjusted taking into account ferritin levels over time. A moderate positive correlation (r=0.581; p=0.003) between the transfusion load and ferritin level, as well as a moderate positive correlation (r=0.416; p=0.043) between the ferritin and creatinine levels were found. In the analyzed sample, 8 patients died in the hospital. The cause of death was progression of the underlying disease with the development of multiple organ failure syndrome.
Conclusion. In the presence of a high transfusion load, the blood ferritin level increases. The higher the ferritin level, the higher the creatinine level. There is a correlation between the presence of CHF and CKD.
Keywords: transfusion load, hemochromatosis, creatinine, chronic heart failure, chronic kidney disease, ferritin
About the Autors
Zinaida D. Mikhailova – Dr.Sci. (Med.), Associate Professor, Consultant, City Clinical Hospital № 38. Address: 22 Chernyshevsky st., Nizhny Novgorod, 603000; e-mail: zinaida.mihailowa@yandex.ru. ORCID: https://orcid.org/0000-0002-0926-6038.
Mikhail D. Matveev – Doctor at the City Clinical Hospital № 38. Address: 22 Chernyshevsky st., Nizhny Novgorod, 603000; e-mail: araxes96@icloud.com. ORCID: https://orcid.org/0000-0002-4597-1981.
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