Anemia Harder to Treat in Black Children With Kidney Disease

TUESDAY April 27, 2010 -- Even when given the same medical treatment, black children with chronic kidney disease have more severe anemia than white patients, a new U.S. study has found.

Anemia, marked by low levels of red blood cells, is diagnosed by measuring levels of the protein hemoglobin, which carries oxygen in and out of red blood cells. In general, hemoglobin levels below 11 grams per deciliter of blood indicate anemia. However, that number is adjusted for a child's age and gender.

In the new study, which included 429 chronic kidney disease patients aged 1 to 16 years at 44 sites, the researchers found that more than 40 percent of the black children had hemoglobin levels below the fifth percentile for their age and gender (considered a critical cutoff point) compared to 29 percent of white children.

Black children had lower hemoglobin than white children (0.6 grams per deciliter on average), and fewer black patients than white patients reached higher hemoglobin levels with treatment. As kidney disease progressed, the hemoglobin gap between the two groups of children widened, the study found.

The findings suggest that biological differences, rather than disparities in access to care and treatment, may explain why black children with chronic kidney disease have more severe anemia.

"What we are observing could very well mean that black children's hemoglobin levels start to plummet once they reach a certain point in their disease," lead investigator Dr. Meredith Atkinson, a pediatric nephrologist at Johns Hopkins Children's Center, said in a Hopkins news release.

It may be necessary to tailor current guidelines for anemia treatment to reflect race, the study authors suggested.

"As we move from one-size-fits-all medicine toward individualized medicine, we should study further racial disparities and, perhaps, adjust hemoglobin targets to reflect what appear to be genetic variations," Atkinson said in the news release.

The study was published online April 26 in the American Journal of Kidney Disease.

More information

The Nemours Foundation has more about chronic kidney disease in children.

Posted: April 2010


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