title: Long-acting erythropoietin stimulating agents for persistent anemia after kidney transplant: risk factors and outcome.
abstract: OBJECTIVE
  Posttransplant anemia is associated with an increased risk of congestive heart failure, left ventricular hypertrophy, and death. The purpose of this study was to evaluate the effect of long-acting erythropoietin-stimulating agents on anemia after kidney transplant.
  
  
  METHODS
  In 2306 kidney transplant recipients, 250 anemic patients (11%) with stable graft function were followed at the Hamed Al-Essa Organ Transplant Centre (Kuwait) and were assessed for anemia. We enrolled 120 patients into this open-label study in 2 groups: group 1 had treatment with darbepoetin alfa (86 patients) and group 2 had continuous erythropoietin receptor activator (34 patients).
  
  
  RESULTS
  Patient age correlated negatively with serum iron level. Serum ferritin correlated negatively with hemoglobin level 6 months after transplant but not at time of transplant. Most patients were women who received their grafts from male donors. The 2 groups were comparable in frequency of rejection and mean hemoglobin and serum albumin levels at 3, 6, 9, and 12 months after transplant. There was no difference between the 2 groups in renal function (estimated glomerular filtration rate); posttransplant complications such as new-onset diabetes after transplant, hypertension, serious bacterial infections, or patient and graft outcomes.
  
  
  CONCLUSIONS
  Anemia is an important problem after kidney transplant, and iron use is suboptimal in kidney transplant recipients. Darbepoetin alfa and continuous erythropoietin receptor activator had comparable positive results.
authors.affiliation: Hamed Al-Essa Organ Transplant Center, Ibn-Sinah Hospital, Sabah Area, Ministry of Health, Kuwait.
authors.forename: Torki
authors.initials: T
authors.lastname: Al-Otaibi
authors.forename: Osama
authors.initials: O
authors.lastname: Gheith
authors.forename: Medhat A
authors.initials: MA
authors.lastname: Halim
authors.forename: Hasanein
authors.initials: H
authors.lastname: Abu Attia
authors.forename: Hani
authors.initials: H
authors.lastname: Mansour
authors.forename: Tarek
authors.initials: T
authors.lastname: Said
authors.forename: Prasad
authors.initials: P
authors.lastname: Nair
authors.forename: Mohamed
authors.initials: M
authors.lastname: Balaha
authors.forename: M R Narayanan
authors.initials: MR
authors.lastname: Nampoory
mesh_terms: D000328:Adult; D000740:Anemia / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D015415:Biomarkers / Q000097:blood; D000068256:Darbepoetin alfa; D004921:Erythropoietin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D006397:Hematinics / Q000627:therapeutic use*; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D007730:Kuwait; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D017467:Receptors, Erythropoietin / Q000819:agonists* / Q000378:metabolism; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D015415:Biomarkers; D006397:Hematinics; D017467:Receptors, Erythropoietin; C508420:continuous erythropoietin receptor activator; D004921:Erythropoietin; D000068256:Darbepoetin alfa; D011092:Polyethylene Glycols