Prevalence of anemia in erythropoietin-treated pediatric as compared to adult chronic dialysis patients.
BACKGROUND
Recent guidelines recommend a target hemoglobin range of 11 to 12 g/dL in pediatric and adult dialysis patients. We compared anemia prevalence in United States Medicare pediatric and adult dialysis patients.


METHODS
Prevalent hemodialysis patients (0 to 19 years, pediatric: N= 1692; adult: N= 352,291) and peritoneal dialysis patients (pediatric: N= 597; adult: N= 39,136) treated with recombinant human erythropoietin (rHuEPO) from 1996 to 2000 were selected. Mean annual hemoglobin values were calculated by modality, age, sex, and race.


RESULTS
Among hemodialysis patients, mean annual hemoglobin values less than 11 g/dL were present in pediatric and adult patients during 54.1% versus 39.8% patient years, respectively (P < 0.0001); for peritoneal dialysis patients, 69.5% versus 55.1% (P < 0.0001). Mean hemoglobin values increased over time and were 11.2, 11.5, 10.8, and 11.2 g/dL for pediatric and adult hemodialysis and peritoneal dialysis patients, respectively, in 2000. Pediatric hemodialysis patients received intravenous iron less frequently than adults (66.3% vs. 82.5% patient years; P < 0.0001).


CONCLUSIONS
Hemoglobin values in rHuEPO-treated pediatric dialysis patients lagged behind those of adult patients, with pediatric patients achieving target hemoglobin values only a minority of the time (45.9% and 30.5% patient years, respectively, for hemodialysis and peritoneal dialysis). Trends show recent improvement in anemia treatment of children on dialysis. Still, further attention to and analysis of rHuEPO and iron therapy in pediatric dialysis patients is warranted.
Chavers
Blanche M
BM
Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota 55455, USA. chave001@tc.umn.edu
Roberts
Tricia L
TL
Herzog
Charles A
CA
Collins
Allan J
AJ
St Peter
Wendy L
WL
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000740:Anemia / Q000188:drug therapy* / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D004921:Erythropoietin / Q000008:administration & dosage*; D005260:Female; D006454:Hemoglobins; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007676:Kidney Failure, Chronic / Q000453:epidemiology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis; D015995:Prevalence; D006435:Renal Dialysis; D017678:Sex Distribution
D006454:Hemoglobins; D004921:Erythropoietin