title: Clinical risk factors associated with the post-transplant anemia in kidney transplant patients.
abstract: Anemia is a very common occurrence in post-renal transplant patients. Post-transplantation anemia (PTA) is associated with significant graft loss or cardiovascular morbidity. The objective of this study is to identify clinical risk factors associated with anemia after kidney transplantation.
  
  
  
  Our retrospective cohort study included a total of 570 renal transplant recipients. For the definition of anemia, we adopted "the lower limit of normal for Hgb concentration of blood" proposed by Beutler E and Waalen J [14], which has adjustments for age, gender and ethnicity. Post-transplant anemia (PTA) was defined as anemia that arose between 30 and 180days after transplantation. Based on this definition, of the 570 renal transplant recipients, 344 patients (62.1%) experienced PTA. The patients were divided into anemic and non-anemic groups, and a total of 20 clinical factors were compared between the two groups.
  
  
  
  In the univariate analysis, age, race, multiple transplants, delayed graft function (DGF), and use of tacrolimus, sirolimus, thymoglobulin, ganciclovir, ACE inhibitors, and ARBs were associated with PTA. In the multivariate analysis, age (>60years old, OR=2.62, p=0.001), race (OR=2.54, p=0.001), and use of sirolimus (OR=2.01, p=0.019), antiviral agents (OR=1.96, p=0.015), thymoglobulin (OR=1.86, p=0.011), and DGF (OR=2.78, p=0.001) remained significant.
  
  
  
  The current results show that undergoing a transplant at age 60 or older, use of sirolimus, antiviral agents, and thymoglobulin are independent clinical risk factors associated with PTA. In terms of ethnicity, AA, MEA, or PI is higher risk for PTA and Hispanic is significantly lower risk for PTA compared to Caucasians.
authors.affiliation: Mendez National Institute of Transplantation, United States; St Vincent Medical Center, Los Angeles, CA, United States; Western University of Health Sciences, Pomona, CA, United States. Electronic address: changy@westernu.edu.
authors.forename: Youngil
authors.initials: Y
authors.lastname: Chang
authors.affiliation: Mendez National Institute of Transplantation, United States; St Vincent Medical Center, Los Angeles, CA, United States; Western University of Health Sciences, Pomona, CA, United States. Electronic address: doctorts1@yahoo.com.
authors.forename: Tariq
authors.initials: T
authors.lastname: Shah
authors.affiliation: Mendez National Institute of Transplantation, United States; St Vincent Medical Center, Los Angeles, CA, United States; Western University of Health Sciences, Pomona, CA, United States. Electronic address: dmin@westernu.edu.
authors.forename: David I
authors.initials: DI
authors.lastname: Min
authors.affiliation: Mendez National Institute of Transplantation, United States; Sahmyook University, Seoul, Republic of Korea. Electronic address: yangjw@syu.ac.kr.
authors.forename: Jae Wook
authors.initials: JW
authors.lastname: Yang
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000740:Anemia / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D000961:Antilymphocyte Serum / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D015331:Cohort Studies; D051799:Delayed Graft Function / Q000188:drug therapy / Q000453:epidemiology*; D005006:Ethnicity; D005260:Female; D006801:Humans; D007668:Kidney / Q000276:immunology / Q000473:pathology*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000188:drug therapy / Q000453:epidemiology*; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D020123:Sirolimus / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D000961:Antilymphocyte Serum; D000998:Antiviral Agents; C512542:thymoglobulin; D020123:Sirolimus
keywords: Post-transplant anemia; Renal transplantation; Risk factors