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

Objectives: Limited data exist on the use of these novel iron therapies in children with chronic kidney disease (CKD). Therefore, we conducted this cross-over study to compare IPC and liposomal iron in pediatric patients with CKD and absolute iron deficiency anemia (IDA). Methods: a cross-over study of 40 CKD children with IDA was conducted. They were randomized to receive either liposomal iron or iron polymaltose complex (IPC) for 3 months. After a 3-month washout period, they were switched to the other therapy. Red cell and iron indices, as well as bone minerals and 25(OH)D3, were measured at baseline and after each 3-month period. Results: Anemia resolved in only 14% of children after IPC and 18% after liposomal iron. There was no statistically significant difference in DHb, DFe, or DTR (transferrin receptor) levels between the groups (p > 0.05). No significant changes in serum ferritin in both groups (p > 0.05). IPC reduced serum phosphorus levels (p = 0.047, 0.038). 70% of IPC recipients experienced adverse effects, compared to 15% of liposomal iron recipients. Conclusion: both IPC and liposomal iron enhance iron status in children with CKD and absolute IDA. Liposomal iron has a better adverse events profile and potentially no impact on bone mineral metabolism compared to IPC.