Anemia in Children with Chronic Kidney Disease
Treatment of anemia in chronic kidney disease includes the following:
Recombinant human erythropoietin: Recombinant human erythropoietin like epoetin alpha and epoetin beta administered as an injection, helps to replace the erythropoietin deficiency and improve anemia. Children sometimes require higher doses than adults; the dosage should be calculated based on the hemoglobin deficit rather than body weight. Darbepoetin alfa, which requires less frequent dosing as compared to recombinant human erythropoietin, may be preferred. It is administered via injection either into the vein or under the skin. Some children may not respond adequately to erythropoietin. This could be due to chronic inflammation, nutritional deficiency, inadequate dialysis, chronic blood loss, associated hyperparathyroidism, and antibodies to erythropoietin.
Iron therapy: Iron deficiency should be treated with intravenous iron. Iron treatment should also be administered with erythropoietin to ensure that enough iron is available for producing new red blood cells. Oral iron treatment in the form of tablets and syrups is not always effective due to reduced absorption from the digestive tract and lack of compliance on the part of the patient. Injection of iron through the vein should be done with caution to avoid iron overload.
Anemia in chronic kidney disease can be controlled by regularly monitoring hemoglobin levels and treating it as early as possible.