Factors associated with anaemia in kidney transplant recipients in the first year after transplantation: a cross-sectional study

BMC Nephrol. 2018 Oct 5;19(1):252. doi: 10.1186/s12882-018-1054-7.

Abstract

Background: Anaemia after kidney transplantation may reduce quality of life, graft or patient survival. We aimed to determine the prevalence and risk factors for anaemia in the initial 12 months after transplantation.

Methods: We conducted a cross-sectional study at 6 and 12 months after transplantation. Anaemia was defined by World Health Organization criteria taking into consideration erythropoietin use. Logistic regression was used to determine the association between demographic, clinical and pharmacological risk factors for the main outcome of moderate-severe anaemia.

Results: A total of 336 transplant recipients were included and the prevalence of moderate-severe anaemia was 27.4% at 6 months and 15.2% at 12 months. Lower kidney function, female gender, transferrin saturation below 10% and proteinuria were associated with moderate-severe anaemia at both time points. Recent intravenous immunoglobulin treatment was associated with anaemia at 6 months. Recent infection and acute rejection were also associated with anaemia 12 months. Around 20% of patients had at least one blood transfusion but they were uncommon beyond 3 months.

Conclusions: Anaemia remains highly prevalent requiring treatment with erythropoietin and transfusions. Most identifiable risk factors relate to clinical problems rather than pharmacological management, while markers of iron-deficiency remain difficult to interpret in this setting.

Keywords: Anaemia; Blood transfusion; Haematinics; Haemoglobin; Iron-deficiency; Kidney transplantation.

MeSH terms

  • Adult
  • Anemia / diagnosis
  • Anemia / etiology*
  • Anemia / therapy
  • Blood Transfusion
  • Cross-Sectional Studies
  • Erythropoietin / therapeutic use
  • Female
  • Graft Survival
  • Hematinics / therapeutic use
  • Humans
  • Immunoglobulins, Intravenous / therapeutic use
  • Immunosuppressive Agents / therapeutic use
  • Kidney Transplantation / adverse effects*
  • Male
  • Middle Aged
  • Postoperative Complications / diagnosis
  • Postoperative Complications / therapy
  • Quality of Life
  • Risk Factors
  • Survival Rate

Substances

  • Hematinics
  • Immunoglobulins, Intravenous
  • Immunosuppressive Agents
  • Erythropoietin