Anemia after kidney transplantation

Emad Abdallah; Emam Waked; Malak Nabil

doi:10.21804/14-1-769

Emad Abdallah Nephrology Department, Theodor Bilharz Research Institute, Cairo, Egypt
Emam Waked Nephrology Department, Theodor Bilharz Research Institute, Cairo, Egypt
Malak Nabil Nephrology Department, Theodor Bilharz Research Institute, Cairo, Egypt

Abstract

Background: Anemia is a major cardiovascular riskfactor in renal disease. It might be appropriate toextrapolate this association of anemia with cardiovasculardisease to renal transplant recipients who continue tohave a significant cardiovascular risk.The aim of our study was to elucidate the prevalence andrisk factors of anemia after kidney transplantation.

Methods: We studied 118 stable adult kidney transplantrecipients [age at transplant ranged between 22 and 58,42 12], 74 (62.7%) were males and 44 were females(37.3%) who received allograft between December 1998and October 2008 and had at least 1 year of posttransplantfollow up data at Sugar Medical Center,Theodor Bilharz Research Institute (TBRI), and HealthInsurance Organization Cairo. Hemoglobin (Hb) level at6 months, and 1 year after renal transplantation wasrecorded, the eGFR was calculated using the MDRDformula. Risk factors for anemia were evaluated usingunivariate and multivariate regression analysis.

Results: Anemia (Hb <12 g/dl in females and <13 g/dl inmales) was common (28.8% at 6 months, 31.4% at 1year). Significant anemia (Hb <11 g/dl in females and<12 g/dl in males) was also common (15.3% at 6 months,16.8% at 1 year). Severe anemia (Hb <10 g/dl in bothgenders) at 6 months post-transplant was less commonaffecting 4 out of 118 (3.4%) patients. At 1 year, 8 out of118 (6.8%) had severe anemia. Univariate andmultivariate analysis showed that a higher serumcreatinine level and lower eGFR were significant riskfactors at 6 months and 1 year post transplant. At 1 year,in addition to higher creatinine level and lower eGFR,female gender and immunosuppressive drugs(azathioprine and sirolimus) also were significant riskfactors.

Conclusions: Anemia is common during the first yearafter kidney transplantation. High serum creatinine, loweGFR, female gender and immunosuppressive drugs[azathioprine, sirolimus] are independent risk factors forpost-transplant anemia.