Anemia is virtually universal at the time of kidney transplantation because chronic kidney disease (CKD) blunts erythropoietin production.Renal transplantation presents multiple complications after its completion, some of them related to the behavior of hemoglobin levels. Researchers conducted a study to determine the behavior and prevalence of anemia and erythrocytosis in the first year after renal transplantation.
They found that mean hemoglobin levels in patients prior to kidney transplantation are usually low in CKD patients but transplantation allows hemoglobin levels to recover. The findings have been published in the Journal Transplantation Proceedings.
In a retrospective, observational study was conducted of a cohort of patients of the 21st Century National Medical Center in Mexico of transplants performed from January 1, 2013 to December 31, 2017. A total of 649 met the inclusion criteria. Pre-transplant hemoglobin (Hb) levels were determined, as well as levels 1 month, 3, 6, 9, and 12 months after transplantation, and the prevalence of anemia and erythrocytosis was determined in each month. Descriptive analysis was performed with measures of central tendency and measures of dispersion. The statistical program SPSS version 25 was used.
In the study of kidney transplant recipients, 73% had had pre-transplant anemia, defined as hemoglobin levels below 12 g/dL, the researchers reported.The mean pre-transplant hemoglobin levels for the study population as a whole was 10.69 g/dL.
It was found found that at 1 year after transplantation, the cohort had a mean hemoglobin level of 14.45 g/dL, or a mean increase 3.76 g/dL compared with pre-transplant levels.
The proportion of patients with anemia and erythrocytosis at 1 year was 12.9% and 5.9%, respectively.
The researchers concluded that renal transplantation allows Hb levels to recover in a multifactorial way; however, the persistence of anemia and erythrocytes creates a study challenge in any transplant unit, due to their prevalence of 12.9 and 5.9% respectively
"Much more information is needed on why patients continue in anemia despite transplantation, and, even more so, why patients reach erythrocytosis 1 year after the transplant," the authors wrote.
For further reference log on to:
Morales KBR, Pérez RE, López JDC, et al. Anemia and erythrocytes: Behavior and prevalence 1 year after kidney transplant. Transplant Proc. 2020 https://doi.org/10.1016/j.transproceed.2020.01.053