Acute Changes in Renal Function Associated With Deferoxamine Therapy

Gideon Koren, Yedidia Bentur, Dawn Strong, Elizabeth Harvey, Julia Klein, Reuben Baumal, Stephen P. Spielberg, Melvin H. Freedman

Research output: Contribution to journalArticlepeer-review

75 Scopus citations


• In three patients who received intravenous deferoxamine there was a twofold to eightfold increase in plasma creatinine level and a parallel decrease in creatinine clearance that resolved when treatment with the drug was discontinued. In two thalassemic patients, diuresis was evident by urine output exceeding fluid intake. The mechanism was studied in dogs that exhibited an acute and significant decrease in inulin and para-aminohippuric acid clearances induced by intravenous deferoxamine. Saline diuresis could prevent the decrease in the glomerular filtration rate but not the decrease in renal blood flow caused by deferoxamine. Deferoxamine induced an acute increase in the fractional excretion of sodium, potassium, chloride, phosphate, and urate, which may explain the relative diuresis observed in two of the patients. In a subsequent experiment, ferrioxamine induced an increase in the fractional excretion of sodium and chloride but did not affect the glomerular filtration rate and renal blood flow. Our studies suggest that adequate hydration may be needed to preserve renal hemodynamics during intravenous deferoxamine therapy. Repeated measurements of renal function should accompany treatment with this agent.

Original languageEnglish
Pages (from-to)1077-1080
Number of pages4
JournalAmerican Journal of Diseases of Children
Issue number9
StatePublished - Sep 1989
Externally publishedYes


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