عندما لا يحقق علاج الحديد أهداف الهيموغلوبين لدى الأطفال المصابين بفقر الدم المرتبط بمرض الكلى المزمن

DOI: 10.1016/j.kint.2025.06.006

ESAs are effective in children, while HIF-PHIs have not been studied in children.

There are insufficient data for efficacy and safety regarding the use of HIF-PHIs for the treatment of children with anemia and CKD G5D or CKD not receiving dialysis.

In people with CKD not receiving dialysis, including kidney transplant recipients and children, the selection of Hb concentration at which ESA therapy is initiated should consider the presence of symptoms attributable to anemia, the potential benefits of higher Hb concentration, and the potential harms of RBC transfusions or ESA therapy (2D).

We advise considering these data as well as patient symptoms, QoL, growth and development, and the need to limit allosensitization from RBC transfusion when deciding when to initiate ESA therapy in children.

In general, weight-based dosing is used for children.

Initial therapy with an ESA aims to increase the Hb concentration by 1.0 g/dl (10 g/l) per month, which is consistent with the findings in clinical trials that used an ESA to treat anemia in people with CKD G5D and CKD not receiving dialysis.

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