title: Clinical profile and post-transplant anaemia in renal transplant recipients restarting dialysis after a failed graft: changing trends between 2001 and 2009.
abstract: BACKGROUND
  The aim of this study was to compare the clinical profile, outcome and the prevalence and management of anaemia between two cohorts of renal transplant patients with graft failure restarting dialysis in 2001 and 2009.
  
  
  METHODS
  Cross-sectional, observational, retrospective and multicentre study of 397 patients in the 2001 cohort and 222 in the 2009 cohort. Data were recorded at 0, 3, 6, 9 and 12 months before the onset of dialysis resumption and during the first 90 days after restarting dialysis (mortality and hospital admission).
  
  
  RESULTS
  Patients in the 2009 cohort were older at the time of inclusion in the study and transplantation, and restarted dialysis therapy with a significantly better glomerular filtration rate. In both cohorts, there was a rapid deterioration of renal function with statistically significant differences in serum creatinine and glomerular filtration rate between the monthly intervals -12 and 0. The mean haemoglobin value at -12 months was 11.6 g/dL [7.2 mmol/L] in the 2001 cohort when compared with 12.3 g/dL [7.6 mmol/L] in the 2009 cohort, and at the time of restarting dialysis 9.6 g/dL [6.0 mmol/L] versus 10.6 g/dL [6.6 mmol/L]. The percentage of patients treated with erythropoiesis-stimulating agents, at any time during the 12 months before readmission to dialysis, increased significantly from 61.5% in the 2001 cohort to 96% in the 2009 cohort. There were no significant differences between the 2001 and 2009 cohorts in mortality rate (8.8 versus 9.0%) or hospital admission (31.5 versus 31.1%) during the study time.
  
  
  CONCLUSIONS
  At restarting dialysis, the proportion of patients with anaemia (and its severity) due to progressive graft nephropathy decreased over the past 8 years, increasing significantly the percentage of patients treated with erythropoietin. Differences in morbimortality after dialysis resumption were not observed, this is probably due to an increase in the age of donors and recipients.
authors.affiliation: Nephrology Service , Hospital Universitario Marqués de Valdecilla , Santander , Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Arias
authors.affiliation: Nephrology Service , Complejo Hospitalario Universitario Carlos Haya , Málaga , Spain.
authors.forename: Domingo
authors.initials: D
authors.lastname: Hernández
authors.affiliation: Nephrology Service , Fundació Puigvert, Universitat Autònoma de Barcelona , Barcelona , Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Guirado
authors.affiliation: Nephrology Service , Hospital Clínic i Provincial, Universitat de Barcelona , Barcelona , Spain.
authors.forename: Josep M
authors.initials: JM
authors.lastname: Campistol
authors.affiliation: Nephrology Service , Hospital Universitario La Fe , Valencia , Spain.
authors.forename: Jaime A
authors.initials: JA
authors.lastname: Sánchez Plumed
authors.affiliation: Nephrology Service , Hospital Central de Asturias , Oviedo , Spain.
authors.forename: Ernesto
authors.initials: E
authors.lastname: Gómez
authors.affiliation: Nephrology Service , Hospital Virgen del Rocío , Sevilla , Spain.
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Gentil
authors.affiliation: Nephrology Service , Hospital General Universitario de Alicante , Alicante , Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: de Santiago
keywords: anaemia/epidemiology; dialysis; erythropoiesis stimulating agents; graft survival; kidney transplantation