title: Anaemia treatment in chronically dialysed children: a multicentre nationwide observational study.
abstract: OBJECTIVE
  Erythropoiesis-stimulating agents (ESAs) are applied as a standard therapy in children with anaemia in chronic kidney disease. The aim of this study was to describe the efficacy and details of ESA treatment in a population of dialysed children in Poland.
  
  
  METHODS
  The study had a prospective observational design and was performed in 12 dialysis centres. The study group comprised 117 dialysed children with a mean age at enrolment of 165.33 (97.18-196.45) months.
  
  
  RESULTS
  Dialysed children were treated mostly with epoietin beta and darbepoietin. The mean dose of ESA was 99 (68-147) U/kg/week with a significant difference between patients on peritoneal dialysis [83 (54-115)] and haemodialysis [134 (103-186)] (p < 0.0001). The mean haemoglobin of all the time-point tests during 6 months was 10.91 ± 1.18 g/dl. The efficacy of anaemia treatment was unsatisfactory in 52% of subjects. In multivariate analysis, initial haemoglobin level <10 g/l, any infection, younger age at first dialysis, malnutrition and inadequate ESA dosage remained significant predictors of anaemia.
  
  
  CONCLUSIONS
  The study revealed that anaemia treatment in Polish children is unsatisfactory. Late commencement of the treatment, inadequate dosing, malnutrition and infections could constitute risk factors for therapy failure.
authors.affiliation: Nephrology Division, Department of Paediatrics and Immunology with Nephrology Division, Polish Mothers' Memorial Hospital Research Institute, Lodz, Poland. ajander@wp.pl
authors.forename: Anna
authors.initials: A
authors.lastname: Jander
authors.forename: Ryszard
authors.initials: R
authors.lastname: Wierciński
authors.forename: Irena
authors.initials: I
authors.lastname: Bałasz-Chmielewska
authors.forename: Monika
authors.initials: M
authors.lastname: Miklaszewska
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Zachwieja
authors.forename: Halina
authors.initials: H
authors.lastname: Borzecka
authors.forename: Jacek
authors.initials: J
authors.lastname: Zachwieja
authors.forename: Irena
authors.initials: I
authors.lastname: Olszak-Szot
authors.forename: Dariusz
authors.initials: D
authors.lastname: Kubicki
authors.forename: Helena
authors.initials: H
authors.lastname: Ziółkowska
authors.forename: Jacek
authors.initials: J
authors.lastname: Rubik
authors.forename: Maria
authors.initials: M
authors.lastname: Szczepańska
authors.forename: Dariusz
authors.initials: D
authors.lastname: Runowski
authors.forename: Wojciech
authors.initials: W
authors.lastname: Fendler
authors.forename: Marcin
authors.initials: M
authors.lastname: Tkaczyk
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000740:Anemia / Q000188:drug therapy* / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D000068256:Darbepoetin alfa; D004909:Erythrocyte Indices; D004921:Erythropoietin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D006397:Hematinics / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy; D008297:Male; D044342:Malnutrition / Q000150:complications; D015999:Multivariate Analysis; D017063:Outcome Assessment, Health Care; D011044:Poland; D011994:Recombinant Proteins / Q000627:therapeutic use; D006435:Renal Dialysis; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D006397:Hematinics; D011994:Recombinant Proteins; C103998:epoetin beta; D004921:Erythropoietin; D000068256:Darbepoetin alfa