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

ABSTRACT

To determine the prevalence and severity of anemia in children and adolescents on chronic hemodialysis and to identify independent predictor for anemia in children on hemodialysis. A 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, Iran. A total of 22 [82%] patients had hemoglobin level of<11 g/dL [anemic] and 12[48%] patients had hemoglobin values<8 g/dL [severe anemia]. The mean age for these patients was 15.5 +/- 3.7 years and the 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 a inverse relation between 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]. Parathyroid hormone [PTH] levels was>200 pg/ml in 16 patients [66%] and>400 pg/ml in 9 patients [37.5%]. There was a reverse correlation between PTH level>200 pg/ml and hemoglobin level [r=-0.505, P=0.046]. The prevalence of anemia in children on hemodialysis 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], low albumin and severe hyperparathyroidism