Oral liposomal iron vs. oral iron polymaltose in children with chronic kidney disease iron deficiency anemia: a cross-over study

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Abstract Background Limited data exist on the use of novel iron therapies in children with chronic kidney disease (CKD). We conducted a cross-over study to compare iron polymaltose complex (IPC) and liposomal iron in pediatric patients with CKD and iron deficiency anemia (IDA). Methods Cross-over study of 33 children with CKD and IDA was conducted. They were randomized into 2 groups (group A: 17 patients, group B: 16 patients) to receive either liposomal iron or IPC for 3 months. After an 8-week washout period, they were switched to the other therapy. Red cell and iron indices, as well as bone minerals and 25(OH)D 3 , were measured at baseline and after each 3-month period. A follow-up visit was conducted at 4 weeks during the treatment period to report any possible adverse events. Results Hb levels increased by at least 1 g/dL in 48% following liposomal iron therapy and 51.5% following IPC therapy. There was no statistically significant difference in ΔHb, ΔFe, ΔsTR (transferrin receptor), or ΔTSAT (transferrin saturation) levels between the groups ( p > 0.05). By mixed model analysis, IPC showed a higher Hb and TSAT and lower TRresponse compared with liposomal iron. IPC, but not liposomal iron, led to a significant reduction in serum phosphorus in both groups. Thirty-six percent of IPC recipients experienced adverse effects, compared to 3% of liposomal iron recipients. Conclusions Both IPC and liposomal iron effectively improved iron status in children with CKD and IDA. However, IPC indicated a superior response, whereas liposomal iron was associated with a more favorable tolerability profile. Graphical abstract

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