Challenges in managing anemia in patients returning to dialysis after transplant failure.

Anemia is typically severe in patients returning to dialysis due to a failed renal transplant. A convergence of factors, including low starting hemoglobin levels, chronic allograft-related inflammation, ongoing immunosuppressive therapy, and inappropriate therapeutic interventions, results in ongoing challenges in anemia management. Regular nursing assessments and appropriate interventions are key to ensuring that a patient-specific management plan yields improved anemia-related outcomes in this high-risk sub-population.