ESPN 50th Annual Meeting

ESPN 2017


 
MAINTENANCE REGIMEN OF INTRAVENOUS IRON SUPPLEMENTATION PREVENTS ANEMIA IN PEDIATRIC HEMODIALYSIS PATIENTS
CAHYANI GITA AMBARSARI 1 EKA LAKSMI HIDAYATI 1 PARTINI PUDJIASTUTI TRIHONO 1 DEDI RACHMADI 2 MURTI ANDRIASTUTI 1 IRAWAN MANGUNATMADJA 1

1- CIPTO MANGUNKUSUMO HOSPITAL
2- HASAN SADIKIN HOSPITAL
 
Introduction:

Anemia in pediatric chronic hemodialysis patients is usually undertreated. Iron supplementation and recombinant human erythropoietin (rHuEPO) have been recommended for improving anemia in hemodialysis patients. However, there are limited data on the optimal response to achieve sustained normal hemoglobin (Hb) level using maintenance regimen of intravenous iron supplementation in children.    

Material and methods:

In this retrospective cohort study, data of two groups were retrieved from the medical records of pediatric patients on regular hemodialysis. Patients in both groups had normal hemoglobin and iron values (transferrin saturation and ferritin serum level). Group 1 (n = 47) were patients receiving two-weekly 2 mg/kgBW/dose of intravenous iron sucrose for 2 doses without adjusted dose; while group 2 (n = 27) did not receive any iron supplementation. Exclusion criteria included hemolytic anemia, bleeding manifestations, hemoglobinopathies, receiving red blood cell or whole blood transfusion, severely malnourished, evidence of active inflammation or infection and incomplete medical record. Primary outcomes were the percentage of patients with reduced Hb and TSAT levels. Secondary outcome was side effects of intravenous iron supplementation.

Results:

We retrieved data of 74 children from the medical records. No difference was found in clinical characteristics and mean values of hemoglobin, ferritin and TSAT between both groups. There was a significant difference (p < 0.001) on the percentage of patients with reduced Hb and TSAT levels between both groups.  No clinical side effects was observed; however, iron overload occurred in 6/47 (12.77%) patients receiving intravenous iron. 

Conclusions:

Maintenance regimen of intravenous iron supplementation should be considered to achieve sustained hemoglobin and iron levels in pediatric hemodialysis patients and it consequently may prevent anemia. The regimen is safe as no clinical side effects were found; however, iron overload may occur.