Related Experiment Video
Updated: Sep 13, 2025
Continuous Manual Exchange Transfusion for Patients with Sickle Cell Disease: An Efficient Method to Avoid Iron Overload
Published on: March 14, 2017
Ferric carboxymaltose use in pediatric kidney transplant recipients with iron deficiency
Diletta Domenica Torres1, Luigi Antonio Moscogiuri2, Giulia Fontò3
1Pediatric Nephrology and Dialysis Unit, "Giovanni XXIII" Hospital, Via Amendola 207, Bari, 70124, Italy.
Insights
Ferric carboxymaltose (FCM) effectively treats iron deficiency anemia in pediatric kidney transplant patients. This intravenous iron therapy improved hemoglobin and iron levels with no adverse effects observed.
Area of Science:
- Pediatric Nephrology
- Transplantation Medicine
- Hematology
Background:
- Anemia is a frequent complication in pediatric kidney transplant recipients.
- Iron deficiency is a common cause of post-transplantation anemia, often poorly responsive to oral iron.
- The safety and efficacy of intravenous ferric carboxymaltose (FCM) in this population were not previously established.
Purpose of the Study:
- To evaluate the safety and efficacy of ferric carboxymaltose (FCM) in pediatric kidney transplant recipients with iron deficiency (ID) and/or iron deficiency anemia (IDA).
Main Methods:
- Single-center, retrospective cohort study.
- Included pediatric kidney transplant patients diagnosed with ID/IDA (KDIGO guidelines) who received FCM between December 2016 and November 2022.
- Assessed hemoglobin, ferritin, transferrin saturation (TSat), and phosphate levels at baseline and follow-up points up to 12 months.
Main Results:
- Fifteen patients with ID (10 with IDA) received FCM.
- Significant increases in hemoglobin (1.2-1.4 g/dL) and ferritin levels were observed up to six months.
- Transferrin saturation improved by 30 days post-treatment.
- No significant decrease in phosphate levels or adverse reactions were noted.
Conclusions:
- Ferric carboxymaltose (FCM) appears to be an effective and well-tolerated treatment for ID/IDA in pediatric kidney transplant recipients.
- Larger, powered trials are needed to confirm these findings.
Background:
Anemia is a common complication in pediatric kidney transplant recipients (KTR). Post-transplantation anemia (PTA) is multifactorial with iron deficiency being a frequent cause. Oral iron supplementation is often ineffective. Ferric carboxymaltose (FCM) is an intravenous iron formulation but its safety and efficacy in pediatric KTR has not yet been established.
Methods:
This is a single-center, retrospective cohort study evaluating all consecutive KT patients diagnosed with iron deficiency (ID) and/or iron deficiency anemia (IDA), defined by KDIGO guidelines, who received FCM between December 2016 and November 2022.
Results:
Fifteen patients had ID and ten of them also showed IDA. Hemoglobin, transferrin saturation percentage (TSat) and ferritin levels were assessed at baseline and at one, three, six and twelve months, after a median (IQR) post-transplant follow-up of 41.8 months (11.3-72.6). At each follow-up time point, the median increase of Hb levels ranged from 1.2 to 1.4 g/dl. Ferritin levels significantly increased up to six months post-treatment, while TSat improved at 30 days. Phosphate levels did not show any decrease throughout follow-up and no adverse reactions were observed in our study population.
Conclusions:
Our experience suggests that FCM is an effective and well-tolerated treatment for pediatric kidney transplant recipients with ID and/or IDA and highlights the need for larger, well-powered trials to definitively test FCM in this population.
Related Concept Videos
01:28Kidney Transplant I: Introduction
01:11Renal Failure: Dose Adjustments
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
01:26Kidney Transplant II: Surgical Procedure
01:16Kidney Transplant III: Nursing Management
01:22Bone Marrow Sampling and Transplants
The transplant begins with high doses of chemotherapy and radiation treatment, which aim to destroy...
01:28Chronic Kidney Disease III: Interprofessional Care