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21 May 2009

Anaemia and erythrocytosis after kidney transplantation and 5-year graft survival

J Pinocy-Mańdok, J Chudek, A Kolonko, A Wiecek

Ann Transplant 2009; 14(1): 51-51 :: ID: 880387


Background: Both anaemia and erythrocytosis frequently occur after kidney
transplantation (KTx). However their infl uence on cardiovascular complications and the risk of kidney graft loss is not well documented. The aim of this study was to analyze the influence of both anaemia and erythrocytosis on kidney graft function and patients outcome in a long-term follow-up after kidney transplantation.
Material/Methods: Two hundred ninety nine consecutive patients with at least 12-month post successful kidney transplantation were enrolled in this study. 90.1% of analysed patients had completed a 5-year follow-up period. Anaemia occurred in 29.5% of patients (in 16.1% Hb <11.0g/dl), while erythrocytosis in 19.1% of patients (including 9.0% with Ht >55%). We have analysed the graft function 12 months after KTx and the impact of anaemia or erythrocytosis on 5-year risk of death and graft loss.
Results: In 58% of anaemic patients low haemoglobin concentration did not
reach normal range in the whole observation time after KTx. The mean eGFR-
MDRD 12 months post KTx was significantly lower in patients with anaemia
(44.9±18.8 ml/min vs. 52.9±17.0 ml/min;p=0.01). Better 12-month graft function was observed in patients with erythrocytosis (59.0±18.4 ml/min). Anaemia but not erythrocytosis was associated with the increased risk of graft loss [RR=3.79 (1.97-7.29); p<0.001]. The risk of death was similar in all subgroups.
Conclusions: Anaemia after KTx is associated with a worse kidney graft function and is a strong predictor of graft loss. Erythrocytosis occurs in patients with excellent kidney graft function; nonetheless it did not increase the risk of graft loss or death when properly treated with phlebotomy.

Keywords: Kidney Transplantation

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Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358