title: Treatment With Darbepoetin During the First Year After Renal Transplantation: The Starting Point.
abstract: BACKGROUND
  Multiple factors are associated with post-transplantation anemia, and renal function is the main factor. The aims of this study were to compare the evolution of hemoglobin in the first year post-transplantation according to darbepoetin (DA) treatment, and factors related to it, to evaluate the difference between earlier versus delayed treatment, and to describe the dose change pattern.
  
  
  METHODS
  We describe a retrospective study of cohorts in 462 transplant recipients (2004-2011). The variables reported were from donor, transplantation recipient, and DA treatment.
  
  
  RESULTS
  In this study, 67.5% of patients were treated with DA, 32.5% were not. The comparison of hemoglobin in both groups during the first year showed a similar evolution with significant differences between consecutive measures until the second trimester. The hemoglobin of the treated group was significantly lower. The evolution of renal function was not different. Multivariate analysis related DA treatment to delayed graft function (DGF) and albuminuria in the first year. Patients with early versus delayed DA introduction did not show a difference regarding length of treatment, but the total dose in the delayed introduction was lower. The evolution of creatinine and hemoglobin was similar in both groups.
  
  
  CONCLUSIONS
  The introduction of DA was related to DGF and albuminuria. The delayed introduction of DA meant the following: less total dose than earlier introduction, no difference in length of treatment, and a similar evolution in hemoglobin and renal function in both groups. The lack of guidelines about DA treatment in renal transplantation makes it difficult to establish a pattern of dose adjustment.
authors.affiliation: Nephrology Department, University Hospital of Granada, Granada, Spain. Electronic address: mariac.ruiz.fuentes.sspa@juntadeandalucia.es.
authors.forename: M D C
authors.initials: MD
authors.lastname: Ruiz-Fuentes
authors.affiliation: Nephrology Department, University Hospital of Granada, Granada, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Pérez-Marfil
authors.affiliation: Statistics and Operations Research Department, University of Jaén, Jaén, Spain.
authors.forename: N
authors.initials: N
authors.lastname: Ruiz-Fuentes
authors.affiliation: Nephrology Department, University Hospital of Granada, Granada, Spain.
authors.forename: C
authors.initials: C
authors.lastname: De Gracia-Guindo
authors.affiliation: Nephrology Department, University Hospital of Granada, Granada, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Osuna-Ortega
mesh_terms: D000068256:Darbepoetin alfa / Q000627:therapeutic use*; D051799:Delayed Graft Function / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006397:Hematinics / Q000627:therapeutic use; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D006397:Hematinics; D000068256:Darbepoetin alfa