Anaemia treatment in chronically dialysed children: a multicentre nationwide observational study

Abstract

Objective.Erythropoiesis-stimulating agents (ESAs) are applied as a standard therapy in children with anaemia in chronic kidney disease. The aim of this study was to describe the efficacy and details of ESA treatment in a population of dialysed children in Poland. Material and methods. The study had a prospective observational design and was performed in 12 dialysis centres. The study group comprised 117 dialysed children with a mean age at enrolment of 165.33 (97.18–196.45) months. Results.Dialysed children were treated mostly with epoietin beta and darbepoietin. The mean dose of ESA was 99 (68–147) U/kg/week with a significant difference between patients on peritoneal dialysis [83 (54–115)] and haemodialysis [134 (103–186)] (p < 0.0001). The mean haemoglobin of all the time-point tests during 6 months was 10.91 ± 1.18 g/dl. The efficacy of anaemia treatment was unsatisfactory in 52% of subjects. In multivariate analysis, initial haemoglobin level <10 g/l, any infection, younger age at first dialysis, malnutrition and inadequate ESA dosage remained significant predictors of anaemia. Conclusions.The study revealed that anaemia treatment in Polish children is unsatisfactory. Late commencement of the treatment, inadequate dosing, malnutrition and infections could constitute risk factors for therapy failure.

Key Words::

• anaemia
• dialysis
• epoietin
• erythropoiesis
• paediatric
• treatment

Acknowledgements

The study was conducted under the auspices of Polish Society of Paediatric Nephrology. The authors express their appreciation to Anna Kamińska for editorial and secretarial assistance. Results presented in this paper have not been published previously in whole or in part, except in abstract format.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.