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Low-Dose Maintenance Intravenous Iron Therapy Can Prevent Anemia in Children with End-Stage Renal Disease Undergoing Chronic Hemodialysis
Joint Authors
Rachmadi, Dedi
Ambarsari, Cahyani Gita
Trihono, Partini Pudjiastuti
Kadaristiana, Agustina
Andriastuti, Murti
Puspitasari, Henny Adriani
Tambunan, Taralan
Pardede, Sudung Oloan
Mangunatmadja, Irawan
Hidayati, Eka Laksmi
Source
International Journal of Nephrology
Issue
Vol. 2020, Issue 2020 (31 Dec. 2020), pp.1-8, 8 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2020-06-01
Country of Publication
Egypt
No. of Pages
8
Main Subjects
Abstract EN
Iron deficiency anemia is common in children with end-stage renal disease (ESRD) on long-term hemodialysis receiving erythropoiesis-stimulating agents.
One approach to maintain the iron profile and hemoglobin levels is maintenance therapy with regular low doses of intravenous (IV) iron after initial iron repletion therapy; however, evidence for the benefits of this approach is lacking.
This study evaluated the effect of IV iron maintenance therapy on anemia in children on regular hemodialysis.
This retrospective cohort study included 41 pediatric ESRD patients with normal hemoglobin and iron status who underwent regular hemodialysis at the Pediatric Dialysis Unit of Cipto Mangunkusumo Hospital, Indonesia, between January 2015 and April 2019.
Among these, 21 received IV iron maintenance therapy with two doses of 2 mg/kg of IV iron sucrose every 2 weeks (the treatment group) and 20 did not (the comparison group).
Changes in hemoglobin and transferrin saturation were assessed after 6 weeks of observation and compared between the two groups.
There was a significant reduction in the mean hemoglobin level compared with the baseline level in the comparison group (21 g/L; 95% CI, 9.3–33 g/L; p=0.001) but not in the treatment group (0.7 g/L; 95% CI, −6.6–8 g/L; p=0.84).
The risk of anemia was lower in the treatment group (relative risk = 0.42; 95% CI, 0.22–0.79; p=0.003).
Although majority of the patients had high baseline ferritin level, this study indicates that in our setting, ferritin may not be a reliable parameter to review the iron status, as it can be affected by chronic inflammation.
Hence, the decision to start IV iron maintenance therapy in patients with hyperferritinemia should consider the patient’s clinical condition and morbidity.
To conclude, the coadministration of IV iron maintenance therapy is beneficial for maintaining hemoglobin levels and preventing anemia in children with ESRD who are undergoing regular hemodialysis, have achieved the target hemoglobin levels, and have normal iron status.
American Psychological Association (APA)
Ambarsari, Cahyani Gita& Trihono, Partini Pudjiastuti& Kadaristiana, Agustina& Rachmadi, Dedi& Andriastuti, Murti& Puspitasari, Henny Adriani…[et al.]. 2020. Low-Dose Maintenance Intravenous Iron Therapy Can Prevent Anemia in Children with End-Stage Renal Disease Undergoing Chronic Hemodialysis. International Journal of Nephrology،Vol. 2020, no. 2020, pp.1-8.
https://search.emarefa.net/detail/BIM-1172752
Modern Language Association (MLA)
Ambarsari, Cahyani Gita…[et al.]. Low-Dose Maintenance Intravenous Iron Therapy Can Prevent Anemia in Children with End-Stage Renal Disease Undergoing Chronic Hemodialysis. International Journal of Nephrology No. 2020 (2020), pp.1-8.
https://search.emarefa.net/detail/BIM-1172752
American Medical Association (AMA)
Ambarsari, Cahyani Gita& Trihono, Partini Pudjiastuti& Kadaristiana, Agustina& Rachmadi, Dedi& Andriastuti, Murti& Puspitasari, Henny Adriani…[et al.]. Low-Dose Maintenance Intravenous Iron Therapy Can Prevent Anemia in Children with End-Stage Renal Disease Undergoing Chronic Hemodialysis. International Journal of Nephrology. 2020. Vol. 2020, no. 2020, pp.1-8.
https://search.emarefa.net/detail/BIM-1172752
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1172752