Pediatric Nephrology

, 26:2077 | Cite as

Iron deficiency in children with early chronic kidney disease

  • Rossana Baracco
  • Sermin Saadeh
  • Rudolph Valentini
  • Gaurav Kapur
  • Amrish Jain
  • Tej K. Mattoo
Brief Report

Abstract

Iron deficiency (ID) contributes to the development of anemia in patients with chronic kidney disease (CKD). The frequency of ID in children with early CKD has not previously been reported. This was a retrospective chart review of children with CKD stages 2 and 3 followed at the CKD clinic of Children’s Hospital of Michigan. ID was defined as low ferritin and transferrin saturation <20%. Patients on iron supplements were considered as iron-deficient cases. There were 50 patients included in the study (72% male) with a mean age of 10.31 (±5.21). The mean glomerular filtration rate (GFR) was 55.4 ml/min/1.73 m2 (±14.61). ID was present in 42% of patients, out of whom almost half (42.9%) presented with anemia. Females had a higher frequency of ID (64.3%). The frequency of ID with anemia increased from 4.3% to 29.6%, (p = 0.03) in stage 2 to stage 3 CKD, respectively. The frequency of ID without anemia also increased with progression of CKD from stage 2 to stage 3, however, the difference was not statistically significant. ID is frequent in patients with early CKD. Monitoring of iron tests and treatment of ID is important in this population of patients.

Keywords

Iron deficiency Anemia Chronic kidney disease Ferritin Transferrin saturation 

References

  1. 1.
    Staples AO, Wong CS, Smith JM, Gipson DS, Filler G, Warady BA, Martz K, Greenbaum LA (2009) Anemia and risk of hospitalization in pediatric chronic kidney disease. Clin J Am Soc Nephrol 4:48–56PubMedCrossRefGoogle Scholar
  2. 2.
    Halterman JS, Kaczorowski JM, Aligne A, Auinger P, Szilagyi P (2001) Iron deficiency and cognitive achievement among school-aged children and adolescents in the United States. Pediatrics 107:1381–1386PubMedCrossRefGoogle Scholar
  3. 3.
    Lozoff D, Jimenez E, Wolf AW (1991) Long-term developmental outcome of infants with iron deficiency. N Engl J Med 325:687–694PubMedCrossRefGoogle Scholar
  4. 4.
    Fadrowski JJ, Pierce CB, Cole SR, Moxey-Mims M, Warady BA, Furth SL (2008) Hemoglobin decline in children with chronic kidney disease: baseline results from the chronic kidney disease in children prospective cohort study. Clin J Am Soc Nephrol 3:457–462PubMedCrossRefGoogle Scholar
  5. 5.
    Koshy SM, Geary DF (2008) Anemia in children with chronic kidney disease. Pediatr Nephrol 23:209–219PubMedCrossRefGoogle Scholar
  6. 6.
    Hudson JQ, Comstock TJ (2001) Considerations for optimal iron use for anemia due to chronic kidney disease. Clin Ther 23:1637–1665PubMedCrossRefGoogle Scholar
  7. 7.
    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–S145CrossRefGoogle Scholar
  8. 8.
    Schwartz GJ, Brion LP, Spitzer A (1987) The use of plasma creatinine concentration for estimating glomerular filtration rate in infants, children, and adolescents. Pediatr Clin North Am 34:571–590PubMedGoogle Scholar
  9. 9.
    Wong H, Mylrea K, Feber J, Drukker A, Filler G (2006) Prevalence of complications in children with chronic kidney disease according to KDOQI. Kidney Int 70:585–590PubMedGoogle Scholar
  10. 10.
    McGonigle RJ, Boineau FG, Beckman B, Ohene-Frempong K, Lewy JE, Shadduck RK, Fisher JW (1995) Erythropoietin and inhibitors of in vitro erythropoiesis in the development of anemia in children with renal disease. J Lab Clin Med 105:449–458Google Scholar
  11. 11.
    Nicolas G, Chauvet C, Viatte L, Danan JL, Bigard X, Devaux I, Beaumont C, Kahn A, Vaulont S (2002) The gene encoding the iron regulatory peptide hepcidin is regulated by anemia, hypoxia, and inflammation. J Clin Invest 110:1037–1044PubMedGoogle Scholar
  12. 12.
    Malyszko J, Malyszko JS, Pawlak K, Mysliwiec M (2006) Hepcidin, iron status, and renal function in chronic renal failure, kidney transplantation, and hemodialysis. Am J Hematol 81:832–837PubMedCrossRefGoogle Scholar
  13. 13.
    Pruchnicki MC, Coyle JD, Hoshaw-Woodard S, Bay WH (2002) Effect of phosphate binders on supplemental iron absorption in healthy subjects. J Clin Pharmacol 42:1171–1176PubMedCrossRefGoogle Scholar
  14. 14.
    Fishbane S, Pollack S, Feldman HI, Joffe MM (2009) Iron indices in chronic kidney disease in the National Health and Nutritional Examination Survey 1988–2004. Clin J Am Soc Nephrol 4:57–61PubMedCrossRefGoogle Scholar
  15. 15.
    Cook JD, Skikne BS (1989) Iron deficiency: definition and diagnosis. J Intern Med 226:349–355PubMedGoogle Scholar

Copyright information

© IPNA 2011

Authors and Affiliations

  • Rossana Baracco
    • 1
  • Sermin Saadeh
    • 1
  • Rudolph Valentini
    • 1
  • Gaurav Kapur
    • 1
  • Amrish Jain
    • 1
  • Tej K. Mattoo
    • 1
  1. 1.Pediatric NephrologyChildren’s Hospital of MichiganDetroitUSA

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