title: Post-transplantation Anemia Predicts Cardiovascular Morbidity and Poor Graft Function in Kidney Transplant Recipients.
abstract: OBJECTIVE
  We aimed to investigate whether low post-transplantation-period hemoglobin levels are predictive of cardiovascular morbidity in terms of left ventricular (LV) hypertrophy and vascular stiffness and to determine the contributing factors of post-transplantation anemia in kidney transplant (KT) recipients.
  
  
  METHODS
  One hundred fifty (mean age, 38.9 ± 10.8 y; 113 male) KT recipients with functioning grafts were enrolled in the study. All subjects underwent clinical and laboratory evaluations (24-hour urinary protein loss, complete blood count) and transthoracic echocardiography to assess LV systolic function. Arterial stiffness was measured by means of carotid-femoral pulse-wave velocity (PWV). Mean hemoglobin levels were analyzed at the 1st, 6th, 12th, and 24th months after transplantation. Patients were divided into 2 groups according to presence of anemia: patients with anemia (group 1; n = 120) and normal (group 2; n = 30).
  
  
  RESULTS
  PWV values (6.8 ± 1.9 m/s vs 6.4 ± 1.1 m/s in groups 1 and 2, respectively; P = .002) and LV mass index (LVMI; 252.1 ± 93.7 g/m(2) vs 161.2 ± 38.5 g/m(2) groups 1 and 2, respectively; P = .001) were significantly higher in group 1. Estimated glomerular filtration rate and (64 ± 28.5 m/min vs 77.8 ± 30 m/min in groups 1 and 2, respectively; P = .001) LV systolic function (57.2 ± 5.8% vs 77.8 ± 30% in groups 1 and 2, respectively; P < .005) were significantly lower in group 1. In regression analysis, LV systolic function and LVMI were predictors of post-transplantation hemoglobin levels.
  
  
  CONCLUSIONS
  Post-transplantation anemia contributes to cardiovascular morbidity by deteriorating LV function and increasing PWV and is therefore associated with poor prognosis for graft survival. Early correction of post-transplantation anemia, especially with the use of erythropoietin, may be beneficial for both graft and recipient survivals.
authors.affiliation: Department of Nephrology, Baskent University Faculty of Medicine, Ankara, Turkey. Electronic address: bahargurlek@gmail.com.
authors.forename: B
authors.initials: B
authors.lastname: Gurlek Demirci
authors.affiliation: Department of Nephrology, Baskent University Faculty of Medicine, Ankara, Turkey.
authors.forename: S
authors.initials: S
authors.lastname: Sezer
authors.affiliation: Department of Nephrology, Baskent University Faculty of Medicine, Ankara, Turkey.
authors.forename: C B
authors.initials: CB
authors.lastname: Sayin
authors.affiliation: Department of Nephrology, Baskent University Faculty of Medicine, Ankara, Turkey.
authors.forename: E
authors.initials: E
authors.lastname: Tutal
authors.affiliation: Department of Nephrology, Baskent University Faculty of Medicine, Ankara, Turkey.
authors.forename: M E
authors.initials: ME
authors.lastname: Uyar
authors.affiliation: Department of Nephrology, Baskent University Faculty of Medicine, Istanbul, Turkey.
authors.forename: F N
authors.initials: FN
authors.lastname: Ozdemir Acar
authors.affiliation: Department of General Surgery, Baskent University Faculty of Medicine, Ankara, Turkey.
authors.forename: M
authors.initials: M
authors.lastname: Haberal
mesh_terms: D000328:Adult; D000740:Anemia / Q000097:blood / Q000453:epidemiology*; D002318:Cardiovascular Diseases; D004452:Echocardiography; D005260:Female; D006085:Graft Survival; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000097:blood / Q000000981:diagnostic imaging / Q000453:epidemiology*; D007676:Kidney Failure, Chronic / Q000097:blood / Q000601:surgery*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D063177:Pulse Wave Analysis; D066027:Transplant Recipients; D059289:Vascular Stiffness; D018487:Ventricular Dysfunction, Left / Q000097:blood / Q000453:epidemiology*; D016277:Ventricular Function, Left