title: Increasing incidence of post-kidney transplant anemia in children.
abstract: Anemia status at 1-year post-kidney transplant was documented retrospectively in 231 pediatric recipients (mean age: 12.6 +/- 5.0, range: 1.9-20.7 years) at Cincinnati Children's Hospital Medical Center between 1978 and 2003. Anemia was present in 59 (25.5%) patients. The prevalence of anemia has increased in the more recent eras (1978-1985: 7.8%, 1986-1997: 29%; 1998-2003: 32%, p < 0.01). Logistic regression analysis determined that the use of calcineurin inhibitors or impaired allograft function predicted anemia at 1-year post-transplant. Kaplan-Meier analysis showed that children with anemia at 1-year post-transplant had a significantly worse overall allograft survival than children without anemia (p = 0.02). However, when data were analyzed using a Cox proportional hazards model, only lower allograft function at 1-year post-transplant, black race and older era, but not anemia, independently predicted worse graft survival in children. This study suggests that the recent increase in the incidence of anemia post-kidney transplant is related to modern immunosuppressive therapy and that post-transplant anemia is more likely a marker of allograft dysfunction in children rather than its cause.
authors.affiliation: Division of Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, OH, USA. mark.mitsnefes@cchmc.org
authors.forename: Mark M
authors.initials: MM
authors.lastname: Mitsnefes
authors.forename: Mirna
authors.initials: M
authors.lastname: Subat-Dezulovic
authors.forename: Philip R
authors.initials: PR
authors.lastname: Khoury
authors.forename: Jens
authors.initials: J
authors.lastname: Goebel
authors.forename: C Frederic
authors.initials: CF
authors.lastname: Strife
mesh_terms: D000293:Adolescent; D000328:Adult; D000740:Anemia / Q000453:epidemiology* / Q000209:etiology*; D044383:Black People; D065095:Calcineurin Inhibitors; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015994:Incidence; D007223:Infant; D007668:Kidney / Q000503:physiopathology; D016030:Kidney Transplantation / Q000009:adverse effects*; D016015:Logistic Models; D008297:Male; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D014184:Transplantation, Homologous
chemical_list: D065095:Calcineurin Inhibitors; D007166:Immunosuppressive Agents