Radoui A, Skalli Z, Haddiya I, Benamar L, Ezzaitouni F, Ouzeddoun N, Bayahia R, Rhou H
Department of Nephrology, Unit of Nephrology-Dialysis-Renal Transplantation, Université Mohammed V, Faculté de Médecine et de pharmacie de Rabat, Morocco.
Transplant Proc. 2010 Nov;42(9):3542-9. doi: 10.1016/j.transproceed.2010.07.092.
Anemia, a common multifactorial problem in kidney transplant recipients, represents an important cardiovascular risk factor. The purpose of this study was to assess anemia prevalence after kidney transplantation, the main factors involved in its occurrence, its cardiovascular consequences, and its impact on patient survival and graft function.
This retrospective study evaluated 69 patients undergoing renal transplantation between January 1998 and September 2008 with ≥1 year of follow-up. For all of the patients, we recorded hemoglobin concentrations before and at 1, 3, 6, 12, 36, and 60 months after transplantation. Anemia was defined as recommended by the American Society of Transplantation: hemoglobin level <12 g/dL in women and <13 g/dL in men. To determine the factors involved in anemia occurrence, we compared 2 groups of patients, with versus without anemia, at various times after renal transplantation.
This study showed a high prevalence of anemia in the early posttransplantation period of 82.7% and 42% of kidney transplantation patients at 1 month and 6 months, respectively. It was mainly related to a low pretransplant hemoglobin level. The prevalence declined to 37.7% at 1 year. Renal graft dysfunction was the most important factor in the occurrence of late post-renal transplantation anemia. The presence of anemia increased the risk of renal graft functional deterioration by a factor of 2.9. The decreased prevalence at 1 year after transplantation was significantly associated with a reduction in left ventricular hypertrophy.
The management of anemia is essential to improve renal graft survival, reduce cardiovascular morbidity, and ensure a better quality of life for renal transplant recipients.
贫血是肾移植受者中常见的多因素问题，是一个重要的心血管危险因素。本研究的目的是评估肾移植后贫血的患病率、其发生的主要相关因素、心血管后果及其对患者生存和移植肾功能的影响。
这项回顾性研究评估了1998年1月至2008年9月期间接受肾移植且随访时间≥1年的69例患者。对于所有患者，我们记录了移植前以及移植后1、3、6、12、36和60个月时的血红蛋白浓度。贫血的定义按照美国移植学会的推荐：女性血红蛋白水平<12 g/dL，男性血红蛋白水平<13 g/dL。为了确定与贫血发生相关的因素，我们比较了肾移植后不同时间点有贫血和无贫血的两组患者。
本研究显示，移植后早期贫血患病率较高，1个月和6个月时分别有82.7%和42%的肾移植患者存在贫血。这主要与移植前血红蛋白水平较低有关。1年时患病率降至37.7%。肾移植功能障碍是肾移植后晚期贫血发生的最重要因素。贫血的存在使肾移植功能恶化的风险增加了2.9倍。移植后1年患病率的下降与左心室肥厚的减轻显著相关。
贫血的管理对于提高肾移植存活率、降低心血管疾病发病率以及确保肾移植受者更好的生活质量至关重要。
