Introduction: Iron deficiency (ID) and iron deficiency anemia (IDA) are the most common iron disorders worldwide. Children with chronic kidney disease (CKD) may suffer from anemia due to a multi-factorial process, one of which, is disturbance in iron homeostasis.
Aim of the study: To assess the effect of oral lactoferrin in treatment of iron deficiency anemia in children with end stage renal disease (ESRD) on regular hemodialysis.
Methods: Sixty pediatric patients with end stage renal disease (ESRD) on regular hemodialysis in Pediatric Dialysis Unit, Children's Hospital, at Ain Shams University, were included in the study to evaluate the effect of oral lactoferrin on treating iron deficiency anemia instead of IV iron sulphate. This is a follow up case study in which all the included patients were on erythropoietin therapy ranging (150-300 IU/Kg) once per week. The patients were subjected to washout period of two weeks in which they were not given IV iron, and that was followed by the initiation of treatment with oral lactoferrin (100 mg bovine lactoferrin) twice daily for 6 months consecutively. Clinical and laboratory evaluation was done at 0 and 6 months after initiation of treatment.
Results: In the current study out of the total valid cases 56.5% (26/46) of the patients had a drop of blood hemoglobin (Hb) level at the end of the six month, 26% (12/46) had a stable Hb level, and 17.4% (8/46) had an elevated Hb level. In this study on the valid cases, it was noted that the mean change of Hb level between 0 month and 6 months had a highly significant decrease in Hb level with (p=0.000) while mean iron and ferritin levels showed non-significant changes with (p=0.125) and (p=0.239) respectively. While TIBC level showed a highly significant decrease with (p=0.001).
Conclusion: Oral lactoferrin can be used as adjuvant therapy for anemia in children on hemodialysis, not the replacing for the IV iron therapy.