title: Post-Transplant Anemia Has Strong Influences on Renal and Patient Outcomes in Living Kidney Transplant Patients.
abstract: BACKGROUND
  Post-transplant anemia (PTA) is a risk factor for mortality and graft loss in kidney transplant patients.
  
  
  METHODS
  In all, 172 patients were included in this study. PTA was defined as hemoglobin <13.0 g/dL in men and 12.0 g/dL in women. The primary outcome of interest was the renal outcome, defined as a 50% increase in serum levels of creatinine, a return to chronic dialysis, and subsequent kidney transplantation (KTx). The secondary outcome was a composite of the primary outcome and death.
  
  
  RESULTS
  At baseline, 75 patients (43.6%) had PTA. During follow-up of a median of 7.3 years, 52 patients (30.2%) had 2-fold higher creatinine levels than at baseline, 24 patients (14.0%) had to return to chronic dialysis or subsequent KTx, and 11 patients (6.4%) died; 8 (4.7%) of the deceased patients had functioning allografts. Univariate regression analyses showed that a lower hemoglobin level and positive proteinuria were significantly associated with both outcomes. After adjusting for important clinical variables, a lower hemoglobin level remained a strong predictor for both outcomes. Restricted cubic splines showed an almost linear inverse association with a hemoglobin level ≥12 g/dL. The risk of the outcomes increased with decreasing tertiles of the baseline hemoglobin level for both men and women, but the associations in women were much weaker than those in men, suggesting a different prognostic value of the hemoglobin level between men and women.
  
  
  CONCLUSIONS
  PTA strongly influenced the renal and patient outcomes in living kidney transplant patients.
authors.affiliation: Department of Advanced Technology for Transplantation, Osaka University Graduate School of Medicine, Suita, Japan. Electronic address: ichimaru@att.med.osaka-u.ac.jp.
authors.forename: N
authors.initials: N
authors.lastname: Ichimaru
authors.affiliation: Department of Nephrology, Osaka University Graduate School of Medicine, Suita, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Obi
authors.affiliation: Department of Urology, Osaka University Graduate School of Medicine, Suita, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Nakazawa
authors.affiliation: Department of Urology, Osaka University Graduate School of Medicine, Suita, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Yamanaka
authors.affiliation: Department of Urology, Osaka University Graduate School of Medicine, Suita, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Kakuta
authors.affiliation: Department of Urology, Osaka University Graduate School of Medicine, Suita, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Abe
authors.affiliation: Department of Advanced Technology for Transplantation, Osaka University Graduate School of Medicine, Suita, Japan.
authors.forename: J-Y
authors.initials: JY
authors.lastname: Kaimori
authors.affiliation: Department of Urology, Osaka University Graduate School of Medicine, Suita, Japan.
authors.forename: R
authors.initials: R
authors.lastname: Imamura
authors.affiliation: Department of Urology, Osaka University Graduate School of Medicine, Suita, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Nonomura
authors.affiliation: Health Care Center, Osaka University, Suita, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Moriyama
authors.affiliation: Department of Advanced Technology for Transplantation, Osaka University Graduate School of Medicine, Suita, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Takahara
mesh_terms: D000328:Adult; D000740:Anemia / Q000097:blood / Q000209:etiology* / Q000401:mortality; D003404:Creatinine / Q000097:blood*; D005260:Female; D006454:Hemoglobins / Q000378:metabolism*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000401:mortality; D019520:Living Donors; D008297:Male; D011379:Prognosis; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends
chemical_list: D006454:Hemoglobins; D003404:Creatinine