Management of Renal Anemia in Children with Chronic Kidney Disease

  • Peter D. Yorgin
  • Joshua Zaritsky


Renal anemia management is on the cusp of ­dramatic changes due to development of novel erythropoiesis-stimulating agents (ESAs) and new understandings of iron metabolism. As a result of a greater understanding of hypoxia-inducible factor (HIF) regulation and erythropoietin receptor binding site kinetics, the next generation of ESAs are being developed. The adverse effects of erythropoietin, which has been the treatment standard for renal anemia, have become more apparent and concerning. The increased risk of cardiac death associated with normalizing hemoglobins in adult dialysis patients and the lack of a survival benefit for cancer patients have pharmaceutical corporations “smelling blood in the water.” The mechanism of action of hepcidin, a new iron-regulating molecule produced by the liver, provides a better understanding of why dialysis patients do not absorb oral iron well. There is also great interest in exploring how new ESAs, and particularly the prolyl hydroxylase inhibitors, impact hepcidin levels.


renal anemia chronic kidney disease children pediatric diaylsis 


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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Division of NephrologyUniversity of California-San Diego School of MedicineSan DiegoUSA
  2. 2.Department of PediatricsMattel Children’s Hospital at UCLALos AngelesUSA

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