Prevalence and Severity of Anemia in Pediatric Hemodialysis Patients; A Single Center Study

Objective: To determine the prevalence and severity of anemia in children and adolescents on chronichemodialysis and to identify independent predictor for anemia in children on hemodialysis.Material Methods: A cross sectional study was performed between September 2005 and January2006. The study population consisted of 25 patients aged 7−20 years on chronic hemodialysis frompediatric hemodialysis centers in Isfahan, Iran.Findings: A total of 22 (82%) patients had hemoglobin level of 11 g/dL (anemic) and 12(48%)patients had hemoglobin values 8 g/dL (severe anemia). The mean age for these patients was15.5±3.7 years and the mean time on chronic dialysis was 20.44± 15.25 months. Anemia was morecommon and more severe among children who were on dialysis for less than 6 months. There was ainverse relation between severity of anemia and duration of hemodialysis (p=0.019, r=-0.465). Nearlyall patients were treated with erythropoietin, Children with more severe anemia received slightly higherdose of erythropoietin (P=0.09, r=0.202). There was a significant difference between serum albuminvalues in anemic patients and patients without anemia (p=0.023). There was a correlation betweenserum albumin and hemoglobin level (r=0.511, P=0.01). Parathyroid hormone (PTH) levels was 200pg/ml in 16 patients (66%) and 400 pg/ml in 9 patients (37.5%). There was a reverse correlationbetween PTH level 200 pg/ml and hemoglobin level (r=-0.505, P=0.046).Conclusion: The prevalence of anemia in children on hemodialysis in Isfahan appears to be higher thanthat reported in the other studies in spite of extensive use of rHuEPO and iron supplementation. Wefound this to be especially true for patients new on hemodialysis (less than 6 months), low albumin andsevere hyperparathyroidism.