Department of Nephrology, Dialysis and Organ Transplantation, CHU Rangueil, Toulouse, France.
Transpl Int. 2010 Mar 1;23(3):277-84. doi: 10.1111/j.1432-2277.2009.00982.x. Epub 2009 Oct 9.
After kidney transplantation, occurrence of anemia in the early post-transplant period (<1 month) is high and arises out of issues that are multifactorial. We performed a retrospective single-center study to assess whether delivery of high doses of erythropoietin-stimulating agents (ESA) within the first week of kidney transplantation, translates at 1 month post-transplant, in to causing less anemia and whether it has an impact on allograft function. Ninety-nine patients were not given ESA (group I), whereas 82 were (250 IU/kg/week; group II). All patients had similar pretransplant and baseline (day 0) variables. Similar numbers of group II patients were still receiving ESA by day 14 (97.5%) and day 30 (89%). Respective figures for group I were 27% and 27%. Independent factors for anemia at 1 month post-transplant included: being male subject, treatment for hypertension at pretransplant, anemia at transplant, a higher mean corpuscular volume at transplant, and an induction therapy using antithymocyte globulins. Independent predictive factors for lower creatinine clearance included being female subjects, having a donor aged >50 years, being a recipient aged >50 years, not treated for hypertension at pretransplant, and no post-transplant ESA therapy. High doses of ESA within the first month of kidney transplantation have no impact on anemia or renal function by 1 month post-transplant.
肾移植后，早期（<1 个月）发生贫血的发生率很高，其原因是多因素的。我们进行了一项回顾性单中心研究，以评估在肾移植后第一周内给予高剂量促红细胞生成素刺激剂（ESA）是否会导致移植后 1 个月贫血减轻，以及它是否会影响移植物功能。99 例患者未给予 ESA（I 组），82 例给予 ESA（250 IU/kg/周；II 组）。所有患者的移植前和基线（第 0 天）变量相似。第 14 天和第 30 天仍有相似数量的 II 组患者接受 ESA（97.5%和 89%）。I 组的相应数字为 27%和 27%。移植后 1 个月贫血的独立因素包括：男性、移植前高血压治疗、移植时贫血、移植时平均红细胞体积较高、使用抗胸腺细胞球蛋白进行诱导治疗。移植后 1 个月估算肾小球滤过率较低的独立预测因素包括：女性、供者年龄>50 岁、受者年龄>50 岁、移植前未治疗高血压、无移植后 ESA 治疗。肾移植后第一个月内给予高剂量 ESA 对移植后 1 个月的贫血或肾功能无影响。
