title: How to define anemia in children with chronic kidney disease?
abstract: In a cross-sectional study, we compared the prevalence of anemia based on age- and gender-specific reference intervals for hemoglobin (Hgb) and hematocrit (Hct) with the Kidney Disease Outcomes Quality Initiative (KDOQI) anemia definition (Hgb < 110 g/L) in 351 children with chronic kidney disease (CKD) stages I-V. Cystatin C-based GFRs were 122 +/- 36 mL/min/1.73 m(2) in patients with stage I CKD (n=196), 76 +/- 8 mL/min/1.73 m(2) for stage II (n=104), 45 +/- 9 mL/min/1.73 m(2) for stage III (n=36), and 22 +/- 5 mL/min/1.73 m(2) in patients with stage IV+V CKD (n=15). Fifty-nine patients received iron therapy and 32 patients were treated with Darbepoetin. For Hgb, a total of 90 patients fit the age and gender derived criteria, compared to only 54 patients identified by the KDOQI guidelines (p=0.0010). Similarly, for Hct, a total of 78 patients fit the age and gender derived criteria, which was a significantly higher proportion than the 56 identified by the KDOQI guidelines (r=0.22, p=0.0435). There was a significant correlation between the GFR and both the Hgb Z-score (p=0.0068) and the Hct Z-score (p=0.0128). There was poor agreement between conventional and KDOQI definitions of anemia in children with CKD.
authors.affiliation: Division of Pediatric Nephrology, Department of Pediatrics, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Canada. guido.filler@lhsc.on.ca
authors.forename: Guido
authors.initials: G
authors.lastname: Filler
authors.forename: Kyle
authors.initials: K
authors.lastname: Mylrea
authors.forename: Janusz
authors.initials: J
authors.lastname: Feber
authors.forename: Hubert
authors.initials: H
authors.lastname: Wong
mesh_terms: D000293:Adolescent; D000328:Adult; D000375:Aging; D000740:Anemia / Q000145:classification / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005919:Glomerular Filtration Rate; D006400:Hematocrit; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007223:Infant; D007501:Iron / Q000627:therapeutic use; D007676:Kidney Failure, Chronic / Q000150:complications*; D008297:Male; D011627:Puberty
chemical_list: D006454:Hemoglobins; D007501:Iron