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Abstract: SA-PO375

Persistent Increase in Serum Ferritin Levels Despite Converting to Permanent Vascular Access in Pediatric Hemodialysis Patients: Pediatric Nephrology Research Consortium Study

Session Information

  • Pediatric Nephrology - III
    November 04, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Pediatric Nephrology

  • 1900 Pediatric Nephrology

Authors

  • Onder, Ali Mirza, Nemours Children's Hospital Delaware, Wilmington, Delaware, United States
  • Grinsell, Matthew M., University of Utah Health, Salt Lake City, Utah, United States
  • Langman, Craig B., Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States

Group or Team Name

  • Pediatric Nephrology Research Consortium.
Background

Our objective was to examine the change in serum ferritin levels after successful conversion to PVA among children who started hemodialysis (HD) using TCC.

Methods

Retrospective chart reviews were completed on subjects from 20 pediatric HD centers. All patients used TCC prior to PVA. Serum ferritin levels were collected at the creation of PVA and for two years thereafter. Statistical methods included hypothesis testing and statistical modeling after adjusting for relevant demographic variables.

Results

There were 11 (11%) arteriovenous grafts (AVG) and 87 (89%) arteriovenous fistulae (AVF). Their mean TCC use before PVA creation was 10.4± 17.3 months. Serum ferritin at PVA creation was elevated at 562.64± 492.34 ng/ml, further increased to 753.84± 561.54 ng/ml (p= <0.001) at first year and remained significantly elevated at second year 759.60 ± 528.11 ng/ml (p= 0.004). The serum ferritin levels did not show statistically significant linear association with respective serum hematocrit values. In a multiple linear regression model, there were three predictors of serum ferritin at first year PVA follow-up which showed significant association; steroid-resistant nephrotic syndrome as primary etiology (β = -438.93; 95% CI: [-845.41, -32.46]; p=0.035), being from a center enrolling >10 cases (β = 319.85; 95% CI: [2.02, 637.68]; p=0.049) and baseline serum ferritin level (β = 17.96; 95% CI: [3.38, 32.53]; p=0.017).

Conclusion

Increasing serum ferritin after conversion to PVA is concerning. This increase is not associated with serum hematocrit trends. Future studies should investigate the correlation of serum transferrin saturation and ferritin levels in pediatric HD patients.