Abstract
BackgroundAnaemia after kidney transplantation may reduce quality of life, graft or patient survival. We aimed to determine the prevalence and risk factors for anaemia in the initial 12 months after transplantation.MethodsWe conducted a cross-sectional study at 6 and 12 months after transplantation. Anaemia was defined by World Health Organization criteria taking into consideration erythropoietin use. Logistic regression was used to determine the association between demographic, clinical and pharmacological risk factors for the main outcome of moderate-severe anaemia.ResultsA total of 336 transplant recipients were included and the prevalence of moderate-severe anaemia was 27.4% at 6 months and 15.2% at 12 months. Lower kidney function, female gender, transferrin saturation below 10% and proteinuria were associated with moderate-severe anaemia at both time points. Recent intravenous immunoglobulin treatment was associated with anaemia at 6 months. Recent infection and acute rejection were also associated with anaemia 12 months. Around 20% of patients had at least one blood transfusion but they were uncommon beyond 3 months.ConclusionsAnaemia remains highly prevalent requiring treatment with erythropoietin and transfusions. Most identifiable risk factors relate to clinical problems rather than pharmacological management, while markers of iron-deficiency remain difficult to interpret in this setting.
Highlights
Anaemia after kidney transplantation may reduce quality of life, graft or patient survival
Known upper gastrointestinal disorders were more common than lower gastrointestinal disorders as risk factors for gastrointestinal bleeding
We refer to the World Health Organization (WHO)-defined moderate-severe anaemia in this study as “anaemia”
Summary
Anaemia after kidney transplantation may reduce quality of life, graft or patient survival. We aimed to determine the prevalence and risk factors for anaemia in the initial 12 months after transplantation. Post-transplant anaemia affects 10–40% of kidney transplant recipients in the first 12 months. The prevalence partly depends on the definition of anaemia and timing post-transplant [1]. Transplant patients have more anaemia than the GFR-matched general population, suggesting that the transplantation process itself may contribute to anaemia [2]. Anaemia requiring transfusions is a risk factor for immunological sensitisation, which may affect future re-transplantation. Post-transplant anaemia is associated with left ventricular hypertrophy, reduced systolic function and long-term mortality [3, 4]. In the French DIVAT study, anaemia at 12 months based on World
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