Intravenous Iron Supplementation in Korean Children on Chronic Dialysis

Cho, Hee-Yeon; Hahn, Hye-Won; Ha, Il-Soo; Cheong, Hae-Il; Choi, Yong

doi:2009.13.2.197

J Korean Soc Pediatr Nephrol > Volume 13(2); 2009 > Article

J Korean Soc Pediatr Nephrol 2009;13(2): 197-206. doi: https://doi.org/10.3339/jkspn.2009.13.2.197

한국 만성 투석 소아 환자에서 정맥용 철분 제제 투여에 관한 연구

조희연, 한혜원, 하일수, 정해일, 최용

¹서울대학교 어린이병원 소아청소년과
²을지의대 소아과청소년과
³을지의대 소아과청소년과
⁴을지의대 소아과청소년과
⁵을지의대 소아과청소년과

Intravenous Iron Supplementation in Korean Children on Chronic Dialysis

Hee-Yeon Cho, Hye-Won Hahn, Il-Soo Ha, Hae-Il Cheong, Yong Choi

¹Department of Pediatrics, Seoul National University Children's Hospital
²Department of Pediatrics, Eulji University School of Medicine
³Department of Pediatrics, Eulji University School of Medicine
⁴Department of Pediatrics, Eulji University School of Medicine
⁵Department of Pediatrics, Eulji University School of Medicine

ABSTRACT

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/$m^2$ ($leq$200 mg) at week 0, 2, 4, and 6. In 9 children on hemodialysis (HD), it was given intravenously as 8 weekly doses of 3 mg/kg ($leq$100 mg) through week 0-7.
Results : After treatment, serum ferritin levels increased significantly in both groups, and TSAT rose significantly in PD group. However, hemoglobin level did not rise significantly in both groups. Children with baseline hemoglobin less than 10 g/dL or baseline TSAT less than 20% showed significantly higher rise of hemoglobin after intravenous iron treatment. To the contrary, those with higher baseline hemoglobin and TSAT levels displayed higher rise in serum ferritin after the treatment. Although no serious adverse event occurred, TSAT levels exceeding 50% were noted in 6 patients in PD group.
Conclusion : This suggests that 3 mg/kg/week of intravenous iron sucrose can be used safely in children on chronic HD, but 200 mg/$m^2$ every other week may incur excessive TSAT level in some patients on chronic PD.