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[Assessment of iron absorption in children with chronic renal insufficiency]
M Roszkowska-Blaim1, J Korniszewska, W Makarewicz
1Katedry i Kliniki Pediatrii i Nefrologii Ak. Med. w Warszawie.
Insights
Iron absorption in children with kidney failure varies based on iron levels. Monitoring iron curves and transferrin saturation index (TSI) helps guide oral iron treatment decisions, even with high ferritin.
Area of Science:
- Pediatric Nephrology
- Clinical Chemistry
- Pharmacokinetics
Context:
- Children with chronic renal failure (CRF) and end-stage renal disease (ESRD) often experience iron metabolism disturbances.
- Assessing iron absorption is crucial for managing anemia in these patients.
Purpose:
- To compare iron absorption curves in children with CRF and ESRD after oral ferrous sulfate administration.
- To evaluate the relationship between iron absorption, serum ferritin, and transferrin saturation index (TSI).
Summary:
- A flat iron absorption curve was observed in patients with high systemic iron and elevated TSI.
- A steep iron absorption curve indicating good absorption was seen in children with low serum ferritin and decreased TSI.
- Impaired iron absorption was noted at serum ferritin levels of 250-500 ng/ml, influenced by initial TSI and serum iron.
- Dialysis methods did not significantly affect iron absorption curves.
Impact:
- Understanding iron absorption dynamics aids in tailoring oral iron therapy for pediatric kidney disease patients.
- This study provides insights for clinicians to administer oral iron even when serum ferritin and TSI are elevated.
- Optimizing iron management can improve anemia treatment outcomes in children with renal failure.
Abstract:
The changes were compared of the iron curve in children with chronic renal failure and with terminal renal failure after oral loading dose of ferrous sulphate. Flat curve of absorption was found in both groups of patients with increased stores of systemic iron and high values of transferrin saturation index (TSI). Steep iron curve and very good absorption were found in all children with decreased serum level of ferritin and decreased TSI. The curves of iron absorption at serum ferritin level 250-500 ng/ml pointed to impaired absorption and depended on the initial TSI value and initial iron level in the serum. No significant differences were found in the shape of iron curve depending on dialysing methods. Studying of the iron curve and values of TSI in certain patients makes easier the decision of administration of treatment with oral iron preparations even with increased values of TSI and ferritin in the serum.