Anemia in Children with Chronic Kidney Disease

Chronic kidney disease is associated with anemia in people of all ages. A recent article published in Nature Reviews Nephrology discussed the risk factors, causes, complications and treatment of anemia in children with chronic kidney disease. Some of the important points of the review are summarized below:

Statistics in North America confirm the high prevalence of anemia in children with kidney disease: Anemia is found in 73% of children with stage 3 chronic kidney disease, 87% of children with stage 4 and >93% of children with stage 5 disease. Thus, the risk for developing anemia increases as the kidney function worsens. Anemia also results in an increased risk of hospitalization in children with kidney disease.

Other factors that increase the risk for developing anemia in kidney disease are:

Treatment of high blood pressure with drugs especially those belonging to the group of ACE inhibitors.

Race: African-American children were found to be more prone to anemia as compared to white Americans.

The anemia in children with chronic kidney disease is caused by multiple factors like deficiency of iron and other nutrients, deficiency of a hormone required for the production of red blood cells called erythropoietin, chronic inflammation, and associated conditions like hyperparathyroidism (increased secretion of parathyroid gland) and accumulation of urea.

The resulting anemia of chronic kidney disease can cause heart-related complications, worsen kidney disease and affect the quality of life of the affected children.

Treatment includes administration of the hormone erythropoietin and replacement of iron.