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Anemia in chronic kidney disease
Meredith A Atkinson1, Bradley A Warady2
1Division of Pediatric Nephrology, Johns Hopkins University School of Medicine, 200 N. Wolfe St, Baltimore, MD, 21287, USA. matkins3@jhmi.edu.
Pediatric Nephrology (Berlin, Germany)
|April 17, 2017
Summary
Anemia is common in children with chronic kidney disease (CKD). Current treatments like erythropoiesis-stimulating agents (ESA) and iron are often insufficient, and new therapies need safety and efficacy assessment in pediatric CKD patients.
Area of Science:
- Pediatric Nephrology
- Hematology
- Chronic Kidney Disease (CKD) Management
Background:
- Anemia is a frequent complication in pediatric chronic kidney disease (CKD), linked to poor health outcomes.
- Key contributors include reduced erythropoietin production and hepcidin-mediated iron restriction, impacting iron availability for red blood cell production.
Purpose of the Study:
- To review the current landscape of anemia management in children with CKD.
- To highlight the limitations of existing therapies and explore emerging treatment options.
Main Methods:
- Literature review of anemia in pediatric CKD.
- Analysis of current treatment strategies, including erythropoiesis-stimulating agents (ESA) and iron supplementation.
- Examination of novel therapeutic agents and their potential application in this population.
Main Results:
- Despite standard treatments (ESA, iron), many children with CKD remain anemic.
- Optimal dosing of ESA and appropriate iron supplementation present challenges, with limited data on adverse effects in children.
- Novel therapies like HIF stabilizers and prolyl hydroxylase inhibitors show promise but lack pediatric data.
Conclusions:
- Current anemia management in pediatric CKD is often suboptimal.
- Further research is needed to establish the safety and efficacy of novel anemia therapies in children with CKD.