Prevalence and severity of anemia in pediatric hemodialysis patients, a single center study

ABSTRACT

This study was conducted to determine the prevalence and severity of anemia in children and adolescents on chronic hemodialysis, and to identify independent predictors of anemia in children on hemodialysis. This cross-sectional study was performed between September 2005 and January 2006. The study population consisted of 25 patients aged 7+20 years on chronic hemodialysis from pediatric hemodialysis centers in Isfahan. A total of 22 [88%] patients had hemoglobin levels of <11 g/dL [anemic] and 12 patients [48%] had hemoglobin levels of <8 g/dL [severe anemia]. The mean age of these patients was 15.5 +/- 3.7 years. Mean time on chronic dialysis was 20.44 +/- 15.25 months. Anemia was more common and more severe among children who were on dialysis for less than 6 months. There was an inverse relationship between the severity of anemia and duration of hemodialysis [P = 0.019, r = - 0.465]. Nearly all patients were treated with erythropoietin, Children with more severe anemia received slightly higher dose of erythropoietin [P = 0.09, r = 0.202]. There was a significant difference between serum albumin values in anemic patients and patients without anemia [P = 0.023]. There was a correlation between serum albumin and hemoglobin level [r = 0.511, P = 0.01]. Intact PTH levels were >200 pg/ml in 16 patients [66%] and >400 pg/ml in 9 patients [37. 5%]. There was a reverse correlation between intact PTH level >200 pg/ml and hemoglobin level [r = -0.505, P = 0.046]. The prevalence of anemia in hemodialysis children in Isfahan appears to be higher than that reported in the other studies in spite of extensive use of rHuEPO and iron supplementation. We found this to be especially true for patients new on hemodialysis [less than 6 months] and in those with low albumin and severe hyperparathyroidism