Jander A, Wierciński R, Bałasz-Chmielewska I, Miklaszewska M, Zachwieja K, Borzecka H, Zachwieja J, Olszak-Szot I, Kubicki D, Ziółkowska H, Rubik J, Szczepańska M, Runowski D, Fendler W, Tkaczyk M. Anaemia treatment in chronically dialysed children: a multicentre nationwide observational study.
ACTA ACUST UNITED AC 2012;
46:375-80. [PMID:
22587334 DOI:
10.3109/00365599.2012.685492]
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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.
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