Impact of very early high doses of recombinant erythropoietin on anemia and allograft function in de novo kidney-transplant patients.
After kidney transplantation, occurrence of anemia in the early post-transplant period (<1 month) is high and arises out of issues that are multifactorial. We performed a retrospective single-center study to assess whether delivery of high doses of erythropoietin-stimulating agents (ESA) within the first week of kidney transplantation, translates at 1 month post-transplant, in to causing less anemia and whether it has an impact on allograft function. Ninety-nine patients were not given ESA (group I), whereas 82 were (250 IU/kg/week; group II). All patients had similar pretransplant and baseline (day 0) variables. Similar numbers of group II patients were still receiving ESA by day 14 (97.5%) and day 30 (89%). Respective figures for group I were 27% and 27%. Independent factors for anemia at 1 month post-transplant included: being male subject, treatment for hypertension at pretransplant, anemia at transplant, a higher mean corpuscular volume at transplant, and an induction therapy using antithymocyte globulins. Independent predictive factors for lower creatinine clearance included being female subjects, having a donor aged >50 years, being a recipient aged >50 years, not treated for hypertension at pretransplant, and no post-transplant ESA therapy. High doses of ESA within the first month of kidney transplantation have no impact on anemia or renal function by 1 month post-transplant.
Kamar
Nassim
N
Department of Nephrology, Dialysis and Organ Transplantation, CHU Rangueil, Toulouse, France. kamar.n@chu-toulouse.fr
Reboux
Anne-Hélène
AH
Cointault
Olivier
O
Esposito
Laure
L
Cardeau-Desangles
Isabelle
I
Lavayssière
Laurence
L
Guitard
Joëlle
J
Wéclawiak
Hugo
H
Rostaing
Lionel
L
D000328:Adult; D000740:Anemia / Q000097:blood / Q000209:etiology / Q000517:prevention & control*; D003404:Creatinine / Q000097:blood; D004921:Erythropoietin / Q000008:administration & dosage*; D005260:Female; D006085:Graft Survival / Q000187:drug effects; D006397:Hematinics / Q000008:administration & dosage*; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007668:Kidney / Q000187:drug effects / Q000503:physiopathology; D016030:Kidney Transplantation / Q000009:adverse effects / Q000502:physiology; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors
D006397:Hematinics; D006454:Hemoglobins; D011994:Recombinant Proteins; D004921:Erythropoietin; D003404:Creatinine