Anemia: a continuing problem following kidney transplantation

Am J Transplant. 2003 Nov;3(11):1426-33. doi: 10.1046/j.1600-6135.2003.00224.x.

Abstract

Cardiovascular disease is a leading cause of death among kidney transplant recipients. Anemia, a risk factor for cardiovascular complications among patients with chronic kidney disease, has not been well characterized in kidney transplant recipients. We performed a retrospective cohort study of the prevalence of and factors associated with anemia among 240 patients who underwent kidney transplantation at our institution. The mean hematocrit (Hct) rose from 33% at 1 month after transplantation to 40% at 12 months after transplantation. The proportion of patients with Hct < 36% was 76% at transplantation and 21% and 36%, 1 year and 4 years after transplantation, respectively. Six months after transplantation, women had higher likelihood (OR = 3.61) of Hct < 36%, while higher Hct at 3 months (OR = 0.67 for 1% higher Hct) and diabetes (OR = 0.14) were associated with a lower likelihood of Hct < 36%. Similar associations were seen 12 months after transplantation. Even among patients with Hct < 30%, only 36% had iron studies, 46% received iron supplementation and 40% received recombinant human erythropoietin. Awareness of factors associated with a lower Hct may prompt better anemia screening and management, potentially improving cardiovascular outcomes among kidney transplant recipients.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Anemia / etiology*
  • Cohort Studies
  • Erythropoietin / therapeutic use
  • Female
  • Glomerular Filtration Rate
  • Hematocrit
  • Humans
  • Iron / blood
  • Kidney Diseases / blood
  • Kidney Diseases / therapy
  • Kidney Transplantation*
  • Male
  • Middle Aged
  • Postoperative Complications*
  • Retrospective Studies
  • Sex Factors
  • Time Factors

Substances

  • Erythropoietin
  • Iron