Analysis and interpretation of Iron studies and Vitamin C levels in paediatric patients with chronic renal failure
Date
2010-08-24
Authors
Lutz, Tracey Leigh
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Abstract
This prospective observational study analysed iron studies and vitamin C levels in patients
with chronic kidney disease attending Johannesburg Hospital Paediatric Nephrology Clinic.
The rationale behind this study was to determine the extent of iron deficiency among patients
in chronic renal failure. Vitamin C deficiency is common among dialysis patients, it is easy
to test for and easy to prevent. This study may assist in guiding future management with
regards to vitamin C supplementation in patients with chronic renal insufficiency on dialysis.
The study contained 45 patients of which 27 (60 %) were male and 18 (40 %) were female.
The ages of the children varied from 2 years 1 month to 19 years and 7 months. The study
included patients from all ethnic groups; 9 were Caucasian, 33 African, 2 Indian and 1
Coloured. Two male patients did not have Vitamin C levels analyzed.
The patients were divided into 3 distinct groups; firstly those patients on haemodialysis (12
patients), those on peritoneal dialysis (22 patients) and those not yet dialysed (11 patients).
In all patients who were not yet on dialysis the GFR ranged between 18.1 and 45
ml/min/1.73m2.
There were no statistically significant differences between the three groups when the results
of the iron studies were analysed. However, despite iron treatment 26.6 % of patients were
iron deficient as indicated by their transferrin saturation which was less than 20 %.
Vitamin C levels were also analysed in this study. Forty one percent of children in chronic
renal failure were vitamin C deficient. There was no statistically significant variability among the three groups. Two patients (4.6%) were noted to be Vitamin C toxic. One of
these patients was haemodialysed; the other was not yet on dialysis.
Vitamin C deficiency in chronic renal insufficient patients on dialysis is easily correctable
when identified. Vitamin C in specific well documented doses is safe to administer to this
group of patients. It will also enhance the absorption of iron and thereby have an indirect
effect on anaemia.
Description
MMed (Paediatrics), Faculty of Health Sciences, University of the Witwatersrand
Keywords
children, kidney failure, iron, ascorbic acid, vitamin c