Afzali Behdad, Al-Khoury Salam, Shah Nilesh, Mikhail Ashraf, Covic Adrian, Goldsmith David
Department of Nephrology and Transplantation, Guy's Hospital, London, UK.
Am J Kidney Dis. 2006 Oct;48(4):519-36. doi: 10.1053/j.ajkd.2006.07.006.
Anemia in the setting of chronic kidney disease is a well-recognized phenomenon that is associated with decreasing renal function and deficiency of or resistance to erythropoietin. However, anemia in the post-renal transplantation setting has received comparatively less attention in the literature. In this review, we aim critically to appraise the available literature regarding posttransplantation anemia, concentrating in particular on the prevalence of posttransplantation anemia, its etiopathogenesis, potential effects on morbidity and mortality, and the rationale for intervention and treatment. Despite deficiencies in the literature, we conclude that posttransplantation anemia is a common phenomenon that can occur either early or late posttransplantation, and its causation is usually multifactorial and includes contributions notably from poor or decreasing renal function, immunosuppression, and iron deficiency. Conversely, there is a shortage of well-conducted prospective studies looking at the morbidity attributable to posttransplantation anemia and a lack of trial evidence to determine whether intervention improves patient morbidity and outcome.
慢性肾脏病背景下的贫血是一种公认的现象，与肾功能下降以及促红细胞生成素缺乏或抵抗有关。然而，肾移植后贫血在文献中受到的关注相对较少。在本综述中，我们旨在批判性地评估关于移植后贫血的现有文献，特别关注移植后贫血的患病率、其病因发病机制、对发病率和死亡率的潜在影响，以及干预和治疗的理论依据。尽管文献存在不足，但我们得出结论，移植后贫血是一种常见现象，可发生在移植后的早期或晚期，其病因通常是多因素的，尤其包括肾功能差或下降、免疫抑制和缺铁。相反，缺乏关于移植后贫血所致发病率的高质量前瞻性研究，也缺乏确定干预是否能改善患者发病率和结局的试验证据。
