Anaemia treatment in chronically dialysed children: a multicentre nationwide observational study

Scand J Urol Nephrol. 2012 Oct;46(5):375-80. doi: 10.3109/00365599.2012.685492. Epub 2012 May 16.

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.

Material and 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.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Age Factors
  • Anemia / drug therapy*
  • Anemia / etiology
  • Child
  • Child, Preschool
  • Cohort Studies
  • Darbepoetin alfa
  • Erythrocyte Indices
  • Erythropoietin / analogs & derivatives*
  • Erythropoietin / therapeutic use
  • Female
  • Hematinics / therapeutic use*
  • Humans
  • Infant
  • Kidney Failure, Chronic* / complications
  • Kidney Failure, Chronic* / therapy
  • Male
  • Malnutrition / complications
  • Multivariate Analysis
  • Outcome Assessment, Health Care
  • Poland
  • Recombinant Proteins / therapeutic use
  • Renal Dialysis
  • Treatment Outcome
  • Young Adult

Substances

  • Hematinics
  • Recombinant Proteins
  • epoetin beta
  • Erythropoietin
  • Darbepoetin alfa