# Renal Findings in Patients with Thalassemia at Abdominal Ultrasound: Should We Still Talk about “Incidentalomas”? Results of a Long-Term Follow-Up

## TL;DR

This study finds that thalassemia patients have a high risk of kidney issues like stones, cysts, and cancer, suggesting regular imaging is needed.

## Contribution

The study identifies new risk factors and long-term changes in renal abnormalities among thalassemia patients using a 10-year follow-up.

## Key findings

- Renal stones were found in 15.2% of patients, with blood consumption, splenectomy, and proteinuria as independent predictors.
- Renal cysts were detected in 18.4% of patients, with age being the only independent predictor.
- The crude incidence rate of RCC was 75.9 cases per 100,000 person-years, with 80% being clear-cell RCC.

## Abstract

We retrospectively collected all ultrasound imaging data of our thalassemia patients over a period of 10 years with the aim of assessing the prevalence and the risk factors of renal stones and cysts. Moreover, we assessed the incidence of renal-cell carcinoma (RCC) among thalassemia patients (133 with thalassemia major (TM) and 157 with thalassemia intermedia (TI)) and its association with demographic and clinical findings. Renal stones were detected in 15.2% of patients. In the multivariable Cox regression analysis, the independent predictors were blood consumption, splenectomy, and proteinuria. Renal cysts were detected in 18.4% of patients. In the multivariable analysis, age emerged as the only independent predictor. After the first detection, 35% of the patients showed changes in the number, size, or grading of renal cysts. During the study period, the crude incidence rate of RCC was 75.9 cases per 100,000 person-years. The most frequent histological subtype (80%) included clear-cell RCC. In total, 80% of patients with RCC had TM and all were positive for hepatitis C virus antibodies. Thalassemia patients are significantly affected by asymptomatic renal diseases such as stones, cysts, and cancer, suggesting the need for regular screening by imaging.