Anemia Among Long-Term Renal Transplant Recipients

The effects of anemia on cardiovascular disease among the end-stage renal
disease (ESRD) population suggest that it may be one of the major factors explaining this
complication among kidney transplant recipients. Systematic investigation into the prevalence
of posttransplantation anemia (PTA) is therefore of critical importance.
Materials and Methods. This cross-sectional study of data from 650 patients followed at
a single outpatient transplant clinic utilized the guidelines of the American Society of
Transplantation to define anemia as a hemoglobin (Hb) �130 g/L in men or �120 g/L in
women.
Results. Among the 39% of patients who were anemic, the prevalence was greater in
women than in men. Serum Hb concentrations significantly correlated with the glomerular
filtration rate (GFR), serum transferrin, the use of angiotensin converting enzyme
inhibitors and mycophenolate mofetil therapy. Upon multivariate analysis, the GFR,
serum transferrin, potential nutritional markers, chronic inflammation, and iron deficiency
were independently and significantly associated with the presence of anemia. Erythropoietin
was administered to 15 (5.7%) anemic patients.
Conclusions. PTA is a prevalent, undertreated condition. Based on our results, we
suggest that protein/energy malnutrition and/or chronic inflammation were independently
associated with anemia.