A KANSAL1, J KANELLIS1,2, AKH LIM1,2
1Department of Nephrology, Monash Health, Clayton, Victoria; 2Department of Medicine, Monash University, Clayton, Victoria
Aim: To determine the prevalence and risk factors for anaemia in kidney transplant recipients in the first 12 months after transplantation.
Background: Anaemia outside the immediate post-operative period appears common. Moderate-severe anaemia may affect quality of life and need for blood transfusions and consequent immunological sensitization. Understanding the risk factors for anaemia may help with its prevention or management.
Methods: A cross-sectional study was conducted at Monash Health at 6 and 12 months for adult kidney transplants performed between Jan 2011 and Dec 2015. The main binary outcome was moderate-severe anaemia defined by WHO criteria. Patients with allograft failure, deceased or lack sufficient clinical data were excluded.
Results: The analysis included 336 transplant recipients, with a mean age of 51 ± 13 years (65% male), 29% live donation and 7% kidney-pancreas transplants. The prevalence of mild anaemia was 28% and 23% at 6 and 12 months, respectively. The prevalence of moderate-severe anaemia was 18% and 10% at 6 and 12 months, respectively. Use of erythropoietin declined from 17% at 6 months to 8% at 12 months. Ferritin and cobalamin levels were lower at 12 months compared to 6 months. In multivariate logistic regression analysis, the risk factors for moderate-severe anaemia at 6 months were female gender, allograft function, intravenous immunoglobulin exposure, transferrin saturation and proteinuria. In the 12 months analysis, the risk factors were allograft function, recent infection, cobalamin levels, serum ferritin and proteinuria.
Conclusions: The frequency and severity of anaemia is less at 12 months compared to 6 months. The risk factors for moderate-severe anaemia are slightly different at 6 and 12 months but allograft function and proteinuria are prevailing factors.