Skip to main content
SpringerLink
Log in

Intravenous iron treatment in paediatric chronic kidney disease patients not on erythropoietin

  • Brief Report
  • Published:
Pediatric Nephrology Aims and scope Submit manuscript

Abstract

Intravenous (IV) iron treatment reduces erythropoietin (EPO) dose in paediatric haemodialysis patients. The efficacy in paediatric nonhaemodialysis patients is less well established. IV 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 IV iron. Five patients were identified. Mean age was 13.3 years and mean IV iron (Venofer) dose = 3.1 mg/kg. Median number of doses = 7 (range 3–10). Hb increased significantly after IV 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 μmol/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). IV 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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

References

  1. Gillespie RS, Wolf FM (2004) Intravenous iron therapy in pediatric hemodialysis patients: a meta-analysis. Pediatr Nephrol 19:662–666

    Article  Google Scholar 

  2. Richardson D, Bartlett C, Jolly H, Will EJ (2001) Intravenous iron for CAPD populations: proactive or reactive strategies? Nephrol Dial Transplant 16:115–119

    Article  CAS  Google Scholar 

  3. Mircescu G, Garneata L, Capusa C, Ursea N (2006) Intravenous iron supplementation for the treatment of anaemia in pre-dialyzed chronic renal failure patients. Nephrol Dial Transplant 21:120–124

    Article  CAS  Google Scholar 

  4. KDOQI; National Kidney Foundation (2006) KDOQI Clinical Practice Guidelines and Clinical Practice Recommendations for Anemia in Chronic Kidney Disease. Am J Kidney Dis 47:S11–S145

    Article  Google Scholar 

  5. Deicher R, Horl WH (2004) Hepcidin: a molecular link between inflammation and anaemia. Nephrol Dial Transplant 19:521–524

    Article  CAS  Google Scholar 

  6. Bamgbola OF, Kaskel F (2005) Role of folate deficiency on erythropoietin resistance in pediatric and adolescent patients on chronic dialysis. Pediatr Nephrol 20:1622–1629

    Article  Google Scholar 

  7. Anbu AT, Kemp T, O’Donnell K, Smith PA, Bradbury MG (2005) Low incidence of adverse events following 90 minute and 3 minute infusions of intravenous iron sucrose in children on erythropoietin. Acta Paediatr 94:1738–1741

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Paediatric Nephrology, Royal Liverpool Children’s Hospital, Eaton Road, Liverpool, L12 2AP, UK

    Henry E. G. Morgan, Richard C. L. Holt, Caroline A. Jones & Brian A. Judd

Authors
  1. Henry E. G. Morgan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Richard C. L. Holt
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Caroline A. Jones
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Brian A. Judd
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Henry E. G. Morgan.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Morgan, H.E.G., Holt, R.C.L., Jones, C.A. et al. Intravenous iron treatment in paediatric chronic kidney disease patients not on erythropoietin. Pediatr Nephrol 22, 1963–1965 (2007). https://doi.org/10.1007/s00467-007-0499-x

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00467-007-0499-x

Keywords

Search

Navigation