Lee Keum Hwa, Park Eujin, Choi Hyun Jin, Kang Hee Gyung, Ha Il-Soo, Cheong Hae Il, Park Young Seo, Cho Heeyeon, Han Kyoung Hee, Kim Seong Heon, Cho Min Hyun, Lee Joo Hoon, Shin Jae Il
Department of Pediatrics, Yonsei University College of Medicine, Yonsei-ro 50, Seodaemun-gu, C.P.O. Box 8044, Seoul 03722, Korea.
Division of Pediatric Nephrology, Severance Children's Hospital, Seoul 03722, Korea.
J Clin Med. 2019 Jan 29;8(2):152. doi: 10.3390/jcm8020152.
Children with chronic kidney disease (CKD) are at high risk of anemia, an important risk factor for cardiovascular disease and poor quality of life. The present study used baseline data from the Korean cohort study for Outcome in patients With Pediatric Chronic Kidney Disease (KNOW-PedCKD). A Total of 437 patients was included in the analyses excluding missing data. The characteristics of patients with and without anemia and those of patients with and without iron deficiency were compared. Logistic regression analysis and Pearson correlation were conducted to evaluate associated risk factors and correlations in children with CKD. Anemia in children with CKD was associated with older age, low body weight and body mass index (BMI) z-score, birth age, preceding glomerulonephritis, decreased estimated glomerular filtration rate (eGFR), low levels of serum albumin and calcium, high levels of serum intact parathyroid hormone (iPTH), and serum phosphorus. Anemia was correlated positively with changes in the BMI z-score, body weight, and serum albumin and cholesterol levels, but correlated negatively with serum calcium, iPTH, ferritin levels, and transferrin saturation. Iron deficiency in children with CKD was associated with young age, low hemoglobin and serum ferritin levels, high BMI z-scores, and low levels of serum iPTH. This is the first nationwide cohort study of anemia in Korean children with CKD and the first prospective pediatric CKD cohort study in Asia. The study results demonstrated that anemia and iron deficiency are affected by various factors, including age, BMI, and levels of serum iPTH. To improve the retrospective outcome of affected children, it is important to understand the effect of each of these factors and to attempt an early intervention to prevent anemia and iron deficiency by regular measurement of these parameters in children at risk.
慢性肾脏病（CKD）患儿患贫血的风险很高，贫血是心血管疾病和生活质量低下的重要风险因素。本研究使用了韩国儿童慢性肾脏病结局队列研究（KNOW-PedCKD）的基线数据。分析中排除缺失数据后共纳入437例患者。比较了有贫血和无贫血患者以及有缺铁和无缺铁患者的特征。进行逻辑回归分析和Pearson相关性分析以评估CKD患儿的相关风险因素和相关性。CKD患儿的贫血与年龄较大、低体重和体重指数（BMI）z评分、出生年龄、既往肾小球肾炎、估计肾小球滤过率（eGFR）降低、血清白蛋白和钙水平低、血清完整甲状旁腺激素（iPTH）水平高以及血清磷有关。贫血与BMI z评分、体重、血清白蛋白和胆固醇水平的变化呈正相关，但与血清钙、iPTH、铁蛋白水平和转铁蛋白饱和度呈负相关。CKD患儿的缺铁与年龄小、血红蛋白和血清铁蛋白水平低、BMI z评分高以及血清iPTH水平低有关。这是韩国CKD患儿贫血的第一项全国性队列研究，也是亚洲第一项前瞻性儿科CKD队列研究。研究结果表明，贫血和缺铁受多种因素影响，包括年龄、BMI和血清iPTH水平。为了改善受影响儿童的回顾性结局，了解这些因素各自的影响并通过定期测量高危儿童的这些参数尝试早期干预以预防贫血和缺铁非常重要。
