title: Intravenous iron treatment in paediatric chronic kidney disease patients not on erythropoietin.
abstract: Intravenous (i.v.) iron treatment reduces erythropoietin (EPO) dose in paediatric haemodialysis patients. The efficacy in paediatric nonhaemodialysis patients is less well established. i.v. iron is routinely given in our institution to these patients, including some who have not started EPO. The effect of this strategy was examined. Patients with chronic kidney disease (CKD) or peritoneal dialysis (PD) not on EPO were identified. Case notes were reviewed for haemoglobin (Hb), red cell and iron indices for 6 months before and at least 3 months after i.v. iron. Five patients were identified. Mean age was 13.3 years and mean i.v. iron (Venofer) dose = 3.1 mg/kg. Median number of doses = 7 (range 3-10). Hb increased significantly after i.v. iron from 11.4 +/- 0.7 to 12.8 +/- 1.3 g/dl (p = 0.02). Mean cell volume increased from 87.7+/-3.4 to 90.1 +/- 3.7 fl (p = 0.01), and mean cell Hb remained unchanged: 29.2 +/- 1.2 to 29.7 +/- 1.0 pg (p = 0.12). Absolute and percentage reticulocyte count remained unchanged. There was no change in iron indices: ferritin 55.1 +/- 31.3 to 97.3 +/- 46.5 ng/ml (p = 0.3), iron 18.9 +/- 6.9 to 18.1 +/- 4.2 micromol/l (p = 0.7), transferrin 1.9 +/- 1.6 to 2.0 +/- 0.1 g/l (p = 1.0), transferrin saturation 35.7 +/- 8.1 to 40.3 +/- 18.0% (p = 0.5). i.v. iron slightly improved Hb levels in five paediatric CKD and PD patients not receiving EPO. This strategy may delay the need for EPO treatment and deserves further evaluation.
authors: Department of Paediatric Nephrology, Royal Liverpool Children's Hospital, Eaton Road, Liverpool L12 2AP, UK. henry.morgan@rlc.nhs.uk
authors: Henry E G
authors: HE
authors: Morgan
authors: Richard C L
authors: RC
authors: Holt
authors: Caroline A
authors: CA
authors: Jones
authors: Brian A
authors: BA
authors: Judd
mesh_terms: D000293:Adolescent; D000740:Anemia / Q000097:blood* / Q000188:drug therapy* / Q000209:etiology; D002648:Child; D004909:Erythrocyte Indices; D004921:Erythropoietin / Q000627:therapeutic use; D005293:Ferritins / Q000097:blood; D006454:Hemoglobins; D006801:Humans; D007275:Injections, Intravenous; D007501:Iron / Q000008:administration & dosage*; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000150:complications* / Q000628:therapy; D010530:Peritoneal Dialysis; D012189:Retrospective Studies
chemical_list: D006454:Hemoglobins; D004921:Erythropoietin; D005293:Ferritins; D007501:Iron
references: Am J Kidney Dis. 2006 May;47(5 Suppl 3):S11-145
references: 16678659
references: Nephrol Dial Transplant. 2004 Mar;19(3):521-4
references: 14767000
references: Pediatr Nephrol. 2004 Jun;19(6):662-6
references: 15052462
references: Nephrol Dial Transplant. 2006 Jan;21(1):120-4
references: 16144853
references: Acta Paediatr. 2005 Dec;94(12):1738-41
references: 16431410
references: Nephrol Dial Transplant. 2001 Jan;16(1):115-9
references: 11209003
references: Pediatr Nephrol. 2005 Nov;20(11):1622-9
references: 16133045