Anemia after kidney transplantation is not completely explained by reduced kidney function.
BACKGROUND
Anemia is prevalent among kidney transplant recipients and likely contributes to mortality and morbidity. Prevalence of anemia is associated strongly with degree of kidney graft dysfunction; however, it remains unclear whether additional transplant-associated factors also contribute.


METHODS
The aim of this study is to compare the prevalence of anemia between 2 cohorts, 1 of kidney transplant recipients (n = 851) and another from the general population (n = 732), sourced from subjects of the AusDiab study and selected by means of propensity score to provide a cohort matched for kidney function (Cockcroft-Gault creatinine clearance).


RESULTS
Average hemoglobin level in kidney transplant recipients was (13.1 g/dL [131 g/L]; range, 9.0 to 18.0 g/dL), significantly less than in the general population (14.3 g/dL [143 g/L]; range, 9.7 to 20.0 g/dL). The prevalence of anemia (hemoglobin < 12.0 g/dL [<120 g/L] for females; <12.5 g/dL [<125 g/L] for males) was almost 10-fold greater in kidney transplant recipients (30.8%) versus the general population (3.4%). Average hemoglobin level was lower in the kidney-transplant-recipient cohort at all levels of creatinine clearance. Considering both cohorts pooled, multivariate analysis showed that transplant status had the strongest association with anemia, followed by sex, creatinine clearance, and age.


CONCLUSIONS
Posttransplantation anemia cannot be attributed solely to impaired kidney function.
Chadban
Steven J
SJ
Renal Medicine and Transplantation, Royal Prince Alfred Hospital and University of Sydney, Camperdown, NSW, Australia. steve.chadban@cs.nsw.gov.au
Baines
Laura
L
Polkinghorne
Kevan
K
Jefferys
Andrew
A
Dogra
Sharan
S
Kanganas
Claire
C
Irish
Ashley
A
Eris
Josette
J
Walker
Rowan
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D000740:Anemia / Q000453:epidemiology* / Q000209:etiology*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007668:Kidney / Q000502:physiology; D007676:Kidney Failure, Chronic / Q000150:complications / Q000453:epidemiology / Q000601:surgery; D007677:Kidney Function Tests; D016030:Kidney Transplantation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology*; D012189:Retrospective Studies