Anemia in children with chronic renal failure Special attention erythrocyte indices and iron deficiency anemia
Keywords:
chronic renal failure, anemia, iron deficiency
Abstract
Background Anemia in chronic renal failure (CRF) has beenproved to influence the quality of life, increasing morbidity and
mortality. Early diagnosis and prompt treatments of anemia are
mandatory to manage CRF appopriately. So far data of anemia in
CRF in Indonesia is limited.
Objective To find out the profile of anemia in children with CRF at
Cipto Mangunkusumo Hospital (CMH), Jakarta, with special atten-
tion in erythrocyte indices and iron deficiency anemia.
Methods Cross-sectional descriptive study was carried out on
patients with CRF and anemia in CMH since October 2003 to April
2004.
Results There were 20 CRF patients, aged between 1 year 3 month-
15 year old, mostly were above 10 year old, 11 patients were males
and 9 were females. The most frequent etiologies were urinary
tract infection (UTI) in 10 cases and nephrotic syndrome in 6 cases.
Of those 20 patients, 14 suffered from anemia with erythrocyte
indices, normochrome normocytic in 9 patients and hypochrome
microcytic in 5 patients. Of 14 anemic patients only 1 patient suf-
fered from iron deficiency anemia of less than 10 mg/l and transferin
saturation of less than 12%. Based on serum iron (SI) concentra-
tion only, 7 patients were diagnosed as having iron deficiency ane-
mia.
Conclusion Most patients with chronic renal failure have
normochrome normocytic anemia. Hypochromic microcytic iron
deficiency anemia is scarcely found in this group of patients.
References
1. Kher KK. Chronic renal failure. In: Kher KK, Makker
SP, editors. Clinical pediatric nephrology. New York:
Mc Graw-Hill, Inc.; 1992. p. 501-41.
2. Trihono PP. Terapi konservatif untuk mencegah
penurunan fungsi ginjal yang progresif pada gagal ginjal.
In: Naskah lengkap SINAS Nefrologi Anak VIII.
Palembang: IDAI; 2001. p. 163-73.
3. Trihono PP. Penatalaksanaan gagal ginjal kronik pada
anak. In: Naskah Lengkap SINAS Nefrologi Children
VII. Ujung Pandang: IDAI; 1998. p. 133-50.
4. Nissenson AR. Introduction to anemia. Am J Kidney
Dis 1998;32:131-2.
5. Foley RN, Parfrey PS, Harnett JD, Kent GM, Murray
DC, Barre PE. The impact of anemia on cardiomyopa-
thy, morbidity, and mortality in end-stage renal dis-
ease. Am J Kidney Dis 1996;28:53-61.
6. Perhimpunan Nefrologi Indonesia. Konsensus
manajemen anemia pada patients gagal ginjal kronik.
Pernefri; 2001.
7. Fivush BA, Jabs K, Neu AM, Sullivan EK, Feld L,
Kohaut E, et al. Chronic renal insufficiency in children
and adolescents: The 1996 annual report of NAPRTCS.
Pediatr Nephrol 1998;12:328-37.
8. Peter WSL, Lambrecht LJ, Macres M. Randomized
cross-over study of adverse reactions and cost impli-
cations of intravenous push compared with infusion of
of iron dextran in hemodialysis patients. Am J Kidney
Dis 1996;28:523-8.
9. Kalantar-Zadeh K, Höffken B, Wünsch H, Fink H,
Kleiner M, Luft FC. Diagnosis of iron deficiency ane-
mia in renal failure patients during the posterythropoietin
era. Am J Kidney Dis 1995;26:292-9.
10. Fernandez-Rodriguez AM, Guindeo-Casasus MC,
Morelo-Labarta T, Dominguez-Cabrera C, Hortal-
Cascon K, Perez-Borges P, et al. Diagnosis of iron defi-
ciency in chronic renal failure. Am J Kidney Dis
1999;34:508-13.
11. Oski FA. Differential diagnosis of anemia. In: Nathan
DG, Oski FA, editors. Hematology of infancy and child-
hood. 4th ed. Philadelphia: W. B. Saunders Co.; 1993.
p. 346-53.
12. Maiz HB, Abderrahim E, Zouaghi K. Anemia and end-
stage renal disease in developing world. Artif Organs.
2002;26:760-4.
13. Rigden SPA. Chronic renal failure. In: Postlethwaite
RJ, editor. Clinical paediatric nephrology. Oxford:
Butterworth-Heinemann Ltd; 1994. p. 266-81.
14. De Maeyer EM. Preventing and controlling iron defi-
ciency anemia through primary health care. A guide
for health admthisstrators and programme managers.
Geneva: WHO; 1989.
15. Dallman PR, Yip R, Oski FA. Iron deficiency and re-
lated nutritional anemias. In: Nathan DG, Oski FA,
editors. Hematology of infancy and childhood. 4th ed.
Philadelphia: Saunders; 1993. p. 413-50.
16. Pudjiadi S. Ilmu gizi klinis pada anak. 4th ed. Jakarta:
Balai Penerbit FKUI; 2001. p. 100.
17. Akinsola A, Durosinmi MO, Akinsola NO. The
haematological profile of Nigerians with chronic renal
failure. Afr J Med Sci 2002;9:13-6.
18. Maandi K, Otoukesh H, Rastegar A, Why SV. Chronic
renal failure in Iranian children. Pediatr Nephrol
2001;16:140-4.
19. Logomarsimo E, Valenzuela A, Cavagnaro F, Solar E.
Chronic renal failure in pediatrics 1996: Chilean sur-
vey. Pediatr Nephrol 1999;13:288-91.
20. Trihono PP. Penatalaksanaan gagal ginjal kronik pada
anak. In: Kumpulan makalah Simposium Nasional
Nefrologi VII and PIBIKA VIII FK UNHAS. Ujung
Pandang, 26-27 Juni 1998.
21. Talwar VK, Gupta HL, Shashinarayan. Clnico-
haematological profile in chronic renal failure. J Assoc
Physicians India 2002;50:228-33.
22. Wu AC, Lesperance L, Bernstein H. Screening for iron
deficiency. Pediatr Rev 2002;23:171-8.
SP, editors. Clinical pediatric nephrology. New York:
Mc Graw-Hill, Inc.; 1992. p. 501-41.
2. Trihono PP. Terapi konservatif untuk mencegah
penurunan fungsi ginjal yang progresif pada gagal ginjal.
In: Naskah lengkap SINAS Nefrologi Anak VIII.
Palembang: IDAI; 2001. p. 163-73.
3. Trihono PP. Penatalaksanaan gagal ginjal kronik pada
anak. In: Naskah Lengkap SINAS Nefrologi Children
VII. Ujung Pandang: IDAI; 1998. p. 133-50.
4. Nissenson AR. Introduction to anemia. Am J Kidney
Dis 1998;32:131-2.
5. Foley RN, Parfrey PS, Harnett JD, Kent GM, Murray
DC, Barre PE. The impact of anemia on cardiomyopa-
thy, morbidity, and mortality in end-stage renal dis-
ease. Am J Kidney Dis 1996;28:53-61.
6. Perhimpunan Nefrologi Indonesia. Konsensus
manajemen anemia pada patients gagal ginjal kronik.
Pernefri; 2001.
7. Fivush BA, Jabs K, Neu AM, Sullivan EK, Feld L,
Kohaut E, et al. Chronic renal insufficiency in children
and adolescents: The 1996 annual report of NAPRTCS.
Pediatr Nephrol 1998;12:328-37.
8. Peter WSL, Lambrecht LJ, Macres M. Randomized
cross-over study of adverse reactions and cost impli-
cations of intravenous push compared with infusion of
of iron dextran in hemodialysis patients. Am J Kidney
Dis 1996;28:523-8.
9. Kalantar-Zadeh K, Höffken B, Wünsch H, Fink H,
Kleiner M, Luft FC. Diagnosis of iron deficiency ane-
mia in renal failure patients during the posterythropoietin
era. Am J Kidney Dis 1995;26:292-9.
10. Fernandez-Rodriguez AM, Guindeo-Casasus MC,
Morelo-Labarta T, Dominguez-Cabrera C, Hortal-
Cascon K, Perez-Borges P, et al. Diagnosis of iron defi-
ciency in chronic renal failure. Am J Kidney Dis
1999;34:508-13.
11. Oski FA. Differential diagnosis of anemia. In: Nathan
DG, Oski FA, editors. Hematology of infancy and child-
hood. 4th ed. Philadelphia: W. B. Saunders Co.; 1993.
p. 346-53.
12. Maiz HB, Abderrahim E, Zouaghi K. Anemia and end-
stage renal disease in developing world. Artif Organs.
2002;26:760-4.
13. Rigden SPA. Chronic renal failure. In: Postlethwaite
RJ, editor. Clinical paediatric nephrology. Oxford:
Butterworth-Heinemann Ltd; 1994. p. 266-81.
14. De Maeyer EM. Preventing and controlling iron defi-
ciency anemia through primary health care. A guide
for health admthisstrators and programme managers.
Geneva: WHO; 1989.
15. Dallman PR, Yip R, Oski FA. Iron deficiency and re-
lated nutritional anemias. In: Nathan DG, Oski FA,
editors. Hematology of infancy and childhood. 4th ed.
Philadelphia: Saunders; 1993. p. 413-50.
16. Pudjiadi S. Ilmu gizi klinis pada anak. 4th ed. Jakarta:
Balai Penerbit FKUI; 2001. p. 100.
17. Akinsola A, Durosinmi MO, Akinsola NO. The
haematological profile of Nigerians with chronic renal
failure. Afr J Med Sci 2002;9:13-6.
18. Maandi K, Otoukesh H, Rastegar A, Why SV. Chronic
renal failure in Iranian children. Pediatr Nephrol
2001;16:140-4.
19. Logomarsimo E, Valenzuela A, Cavagnaro F, Solar E.
Chronic renal failure in pediatrics 1996: Chilean sur-
vey. Pediatr Nephrol 1999;13:288-91.
20. Trihono PP. Penatalaksanaan gagal ginjal kronik pada
anak. In: Kumpulan makalah Simposium Nasional
Nefrologi VII and PIBIKA VIII FK UNHAS. Ujung
Pandang, 26-27 Juni 1998.
21. Talwar VK, Gupta HL, Shashinarayan. Clnico-
haematological profile in chronic renal failure. J Assoc
Physicians India 2002;50:228-33.
22. Wu AC, Lesperance L, Bernstein H. Screening for iron
deficiency. Pediatr Rev 2002;23:171-8.
Published
2016-10-18
How to Cite
1.
B A, Trihono P, Firmansyah A. Anemia in children with chronic renal failure Special attention erythrocyte indices and iron deficiency anemia. PI [Internet]. 18Oct.2016 [cited 25Nov.2024];46(4):154-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/920
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Received 2016-10-14
Accepted 2016-10-14
Published 2016-10-18
Accepted 2016-10-14
Published 2016-10-18
