Torres Diletta Domenica, Moscogiuri Luigi Antonio, Fontò Giulia, Giordano Paolo, Carbone Vincenza, Martino Marida, Santangelo Luisa, Giordano Mario
Pediatric Nephrology and Dialysis Unit, "Giovanni XXIII" Hospital, Via Amendola 207, Bari, 70124, Italy.
Pediatric Unit, "Perrino" Hospital, Brindisi, Italy.
Pediatr Nephrol. 2025 Jul 26. doi: 10.1007/s00467-025-06869-0.
Anemia is a common complication in pediatric kidney transplant recipients (KTR). Post-transplantation anemia (PTA) is multifactorial with iron deficiency being a frequent cause. Oral iron supplementation is often ineffective. Ferric carboxymaltose (FCM) is an intravenous iron formulation but its safety and efficacy in pediatric KTR has not yet been established.
This is a single-center, retrospective cohort study evaluating all consecutive KT patients diagnosed with iron deficiency (ID) and/or iron deficiency anemia (IDA), defined by KDIGO guidelines, who received FCM between December 2016 and November 2022.
Fifteen patients had ID and ten of them also showed IDA. Hemoglobin, transferrin saturation percentage (TSat) and ferritin levels were assessed at baseline and at one, three, six and twelve months, after a median (IQR) post-transplant follow-up of 41.8 months (11.3-72.6). At each follow-up time point, the median increase of Hb levels ranged from 1.2 to 1.4 g/dl. Ferritin levels significantly increased up to six months post-treatment, while TSat improved at 30 days. Phosphate levels did not show any decrease throughout follow-up and no adverse reactions were observed in our study population.
Our experience suggests that FCM is an effective and well-tolerated treatment for pediatric kidney transplant recipients with ID and/or IDA and highlights the need for larger, well-powered trials to definitively test FCM in this population.
贫血是小儿肾移植受者（KTR）常见的并发症。移植后贫血（PTA）是多因素导致的，缺铁是常见原因。口服铁剂补充通常无效。羧基麦芽糖铁（FCM）是一种静脉用铁制剂，但其在小儿KTR中的安全性和有效性尚未确定。
这是一项单中心回顾性队列研究，评估了2016年12月至2022年11月期间所有连续接受FCM治疗的、根据KDIGO指南诊断为缺铁（ID）和/或缺铁性贫血（IDA）的肾移植患者。
15例患者存在ID，其中10例也表现为IDA。在中位（IQR）移植后随访41.8个月（11.3 - 72.6）后的基线、1个月、3个月、6个月和12个月时评估血红蛋白、转铁蛋白饱和度百分比（TSat）和铁蛋白水平。在每个随访时间点，血红蛋白水平的中位数升高范围为1.2至1.4 g/dl。铁蛋白水平在治疗后6个月内显著升高，而TSat在30天时有所改善。随访期间磷酸盐水平未见下降，且在我们的研究人群中未观察到不良反应。
我们的经验表明，FCM是治疗小儿肾移植受者ID和/或IDA的一种有效且耐受性良好的治疗方法，并强调需要进行更大规模、有充分效力的试验来明确在该人群中测试FCM。
