J Korean Soc Pediatr Nephrol.
2009 Oct;13(2):197-206.
Intravenous Iron Supplementation in Korean Children on Chronic Dialysis
- Affiliations
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- 1Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea. ilsooha@snu.ac.kr
- 2Department of Pediatrics, Eulji University School of Medicine, Seoul, Korea.
Abstract
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PURPOSE: Limited information is available on experiences of intravenous iron treatment in children. In this study, iron sucrose was administered intravenously to determine its effect, the factors predicting outcome, and safety in children on chronic dialysis.
METHODS
Twenty-one children whose serum ferritin levels were less than 100 ng/mL or transferrin saturations (TSAT) were less than 20% were enrolled. In 12 children on peritoneal dialysis (PD), the drug was infused intravenously as 200 mg/m2 (< or =200 mg) at week 0, 2, 4, and 6. In 9 children on hemodialysis (HD), it was given intravenously as 8 weekly doses of 3 mg/kg (< or =100 mg) through week 0-7.
RESULTS
After treatment, serum ferritin levels increased significantly in both groups, and TSAT rose significantly in PD group. However, hemoglobin level did not rise significantly in both groups. Children with baseline hemoglobin less than 10 g/dL or baseline TSAT less than 20% showed significantly higher rise of hemoglobin after intravenous iron treatment. To the contrary, those with higher baseline hemoglobin and TSAT levels displayed higher rise in serum ferritin after the treatment. Although no serious adverse event occurred, TSAT levels exceeding 50% were noted in 6 patients in PD group.
CONCLUSION
This suggests that 3 mg/kg/week of intravenous iron sucrose can be used safely in children on chronic HD, but 200 mg/m2 every other week may incur excessive TSAT level in some patients on chronic PD.
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