Evaluating iron replacement therapies in pediatric CKD: A comparative analysis of oral liposomal iron, iron supported lactoferrin and IV iron Dextran

Nancy Kamboj 1, Aayush 2, Rida Asghar 3, Samreen Rizwan Ahmed Shaikh 4, Shelja Sharma 5, Srijamya 6, * and Munawar Izhar 7

1 Pt. B D Sharma University of Health Sciences, Rohtak, Haryana, India.
2 NCR Institute Of Medical Sciences, Meerut, Uttar Pradesh, India.
3 Lahore Medical and Dental College, Lahore, Pakistan.
4 Ivane Javakhishvili Tbilisi State University, Tbilisi, Georgia.
5 Rajasthan University of Health Sciences, Jaipur, Rajasthan, India.
6 Faculty of Medicine, Ivane Javakhishvili Tbilisi State University, Tbilisi, Georgia.
7 Department of Nephrology, Chicago Hospitals and Collaborative Research Institute, Chicago, Illinois, United States.
 
Review Article
World Journal of Advanced Research and Reviews, 2024, 23(02), 1293–1300
Article DOI: 10.30574/wjarr.2024.23.2.2484
 
Publication history: 
Received on 06 July 2024; revised on 13 August 2024; accepted on 16 August 2024
 
Abstract: 
CKD is defined as longstanding kidney damage and reduction in renal function. The global burden of CKD in the pediatric population is 15 per million, with congenital renal anomalies and hereditary disorders being the primary causes. Of these, 10% of patients require RRT. The development of anemia in chronic disease is a significant concern as the disease progresses. This condition exacerbates the pathological state by increasing the risk of infection, inevitably resulting in mortality.
The study aims to establish the comparative analysis of three types of iron replacement therapies including oral liposomal iron, iron supported lactoferrin and IV iron dextran by evaluating their safety and efficacy corresponding to the different stages of CKD in pediatric population.
A comparison between all three variants of iron replacement therapy shows oral liposomal iron provides higher bioavailability and tolerance but effective only in lower CKD stages. In IV iron dextran, rapid iron store replenishment has been observed, but with significant side effects, including the risk of severe hypersensitivity reaction. Conversely, oral iron-supported lactoferrin has demonstrated a maximal iron recovery response after six months of therapy, but with frequent gastrointestinal side effects.
 
Keywords: 
Chronic kidney disease; Pediatrics; Iron replacement therapy; Liposomal iron; Iron dextran
 
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