Journal of Nephrology & Therapeutics

Renal involvement and proteinuria in the setting of hemosiderosis are regarded as exceptionally rare and even more unusual to be reported in the context of alpha thalassemia owing to the underdiagnosis of these cases and the renal manifestations being non-standard presentation. This study reports to you a case of 36 years-old female, who was previously known to have alpha-thalassemia and presented with an unexplained proteinuria despite thorough investigations. Extensive lab work failed to unravel the trigger for her manifestations, which pressed for the need for further evaluation via kidney biopsy and the biopsy uncovered severe iron deposition within the renal structure suggesting that it might be the effect of hemosiderosis on kidneys. This case was initially managed by Valsartan and then shifted to Empagliflozin to control her persistent proteinuria and it managed to some extent, but it still was progressive. This case emphasizes the importance of early consideration of chronic kidney disease screening in cases of chronic hemolytic anemia including alpha thalassemia for earlier intervention and possible prevention of progressive decline in kidney functions.