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Anemia and Iron Deficiency in Children with Chronic Kidney Disease (CKD): Data from the Know-Ped CKD Study

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
Department of Pediatrics, Hallym University Kangnam Sacred Heart Hospital, Seoul 07441, Korea
Department of Pediatrics, Seoul National University Children’s Hospital & Seoul National University College of Medicine, Seoul 03080, Korea
Department of Pediatrics, Asan Medical Center Children’s Hospital, University of Ulsan College of Medicine, 88, Olympic-ro 43-Gil, Songpa-Gu, Seoul 05505, Korea
Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea
Department of Pediatrics, Jeju National University School of Medicine, Jeju 63241, Korea
Department of Pediatrics, Pusan National University Children’s Hospital, Yangsan 50612, Korea
Department of Pediatrics, Kyungpook National University, School of Medicine, Daegu 41404, Korea
Institute of Kidney Disease Research, Yonsei University College of Medicine, Seoul 03722, Korea
Authors to whom correspondence should be addressed.
These authors are contributed equally to this work.
These authors are contributed equally to this work.
J. Clin. Med. 2019, 8(2), 152;
Received: 5 December 2018 / Revised: 14 January 2019 / Accepted: 15 January 2019 / Published: 29 January 2019
PDF [642 KB, uploaded 29 January 2019]


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. View Full-Text
Keywords: anemia; iron deficiency; chronic kidney disease anemia; iron deficiency; chronic kidney disease
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

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Lee, K.H.; Park, E.; Choi, H.J.; Kang, H.G.; Ha, I.-S.; Cheong, H.I.; Park, Y.S.; Cho, H.; Han, K.H.; Kim, S.H.; Cho, M.H.; Lee, J.H.; Shin, J.I. Anemia and Iron Deficiency in Children with Chronic Kidney Disease (CKD): Data from the Know-Ped CKD Study. J. Clin. Med. 2019, 8, 152.

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