Anemia after kidney transplantation

Abstract

Background: Anemia is a major cardiovascular riskfactor in renal disease. It might be appropriate toextrapolate this association of anemia with cardiovasculardisease to renal transplant recipients who continue tohave a significant cardiovascular risk.The aim of our study was to elucidate the prevalence andrisk factors of anemia after kidney transplantation. Methods: We studied 118 stable adult kidney transplantrecipients [age at transplant ranged between 22 and 58,42 12], 74 (62.7%) were males and 44 were females(37.3%) who received allograft between December 1998and October 2008 and had at least 1 year of posttransplantfollow up data at Sugar Medical Center,Theodor Bilharz Research Institute (TBRI), and HealthInsurance Organization Cairo. Hemoglobin (Hb) level at6 months, and 1 year after renal transplantation wasrecorded, the eGFR was calculated using the MDRDformula. Risk factors for anemia were evaluated usingunivariate and multivariate regression analysis. Results: Anemia (Hb <12 g/dl in females and <13 g/dl inmales) was common (28.8% at 6 months, 31.4% at 1year). Significant anemia (Hb <11 g/dl in females and<12 g/dl in males) was also common (15.3% at 6 months,16.8% at 1 year). Severe anemia (Hb <10 g/dl in bothgenders) at 6 months post-transplant was less commonaffecting 4 out of 118 (3.4%) patients. At 1 year, 8 out of118 (6.8%) had severe anemia. Univariate andmultivariate analysis showed that a higher serumcreatinine level and lower eGFR were significant riskfactors at 6 months and 1 year post transplant. At 1 year,in addition to higher creatinine level and lower eGFR,female gender and immunosuppressive drugs(azathioprine and sirolimus) also were significant riskfactors. Conclusions: Anemia is common during the first yearafter kidney transplantation. High serum creatinine, loweGFR, female gender and immunosuppressive drugs[azathioprine, sirolimus] are independent risk factors forpost-transplant anemia.