title: Anemia: a continuing problem following kidney transplantation.
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.
authors.affiliation: Department of Surgery, Tufts-New England Medical Center, Boston, MA, USA.
authors.forename: T Christian H
authors.initials: TC
authors.lastname: Mix
authors.forename: Waqar
authors.initials: W
authors.lastname: Kazmi
authors.forename: Samina
authors.initials: S
authors.lastname: Khan
authors.forename: Robin
authors.initials: R
authors.lastname: Ruthazer
authors.forename: Richard
authors.initials: R
authors.lastname: Rohrer
authors.forename: Brian J G
authors.initials: BJ
authors.lastname: Pereira
authors.forename: Annamaria T
authors.initials: AT
authors.lastname: Kausz
mesh_terms: D000293:Adolescent; D000328:Adult; D000740:Anemia / Q000209:etiology*; D015331:Cohort Studies; D004921:Erythropoietin / Q000627:therapeutic use; D005260:Female; D005919:Glomerular Filtration Rate; D006400:Hematocrit; D006801:Humans; D007501:Iron / Q000097:blood; D007674:Kidney Diseases / Q000097:blood / Q000628:therapy; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D012737:Sex Factors; D013997:Time Factors
chemical_list: D004921:Erythropoietin; D007501:Iron