Department of Internal Medicine, Botucatu Medical School, Botucatu, ZIP Code: 18.610-000, Brazil.
Int Urol Nephrol. 2012 Feb;44(1):263-8. doi: 10.1007/s11255-010-9854-0. Epub 2010 Dec 14.
Post-transplant anemia is multifactorial and highly prevalent. Some studies have associated anemia with mortality and graft failure. The purpose of this study was to assess whether the presence of anemia at 1 year is an independent risk factor of mortality and graft survival.
All patients transplanted at a single center who survived at least 1 year after transplantation and showed no graft loss (n = 214) were included. Demographic and clinical data were collected at baseline and at 1 year. Patients were divided into two groups (anemic and nonanemic) based on the presence of anemia (hemoglobin < 130 g/l in men and 120 g/l in women).
Baseline characteristics such as age, gender, type of donor, CKD etiology, rejection, and mismatches were similar in both groups. Creatinine clearance was similar in both anemic and nonanemic groups (69.32 ± 29.8 × 75.69 ± 30.5 ml/mim; P = 0.17). A Kaplan-Meier plot showed significantly poorer death-censored graft survival in the anemic group, P = 0.003. Multivariate analysis revealed that anemic patients had a hazard ratio for the graft loss of 3.85 (95% CI: 1.49-9.96; P = 0.005).
In this study, anemia at 1 year was independently associated with death-censored graft survival and anemic patients were 3.8-fold more likely to lose the graft.
移植后贫血是多因素的,且高度普遍。一些研究将贫血与死亡率和移植物失功相关联。本研究的目的是评估在 1 年时是否存在贫血是死亡率和移植物存活的独立危险因素。
所有在单中心接受移植且在移植后至少存活 1 年且未发生移植物失功的患者(n = 214)均被纳入。在基线和 1 年时收集了人口统计学和临床数据。根据贫血的存在(男性血红蛋白 < 130 g/l,女性血红蛋白 < 120 g/l)将患者分为两组(贫血组和非贫血组)。
两组的基线特征如年龄、性别、供者类型、CKD 病因、排斥反应和错配等均相似。贫血组和非贫血组的肌酐清除率相似(69.32 ± 29.8 × 75.69 ± 30.5 ml/min;P = 0.17)。Kaplan-Meier 图显示贫血组的死亡风险校正移植物存活率显著较差,P = 0.003。多变量分析显示贫血患者的移植物失功风险比为 3.85(95%CI:1.49-9.96;P = 0.005)。
在本研究中,1 年时的贫血与死亡风险校正移植物存活率独立相关,贫血患者发生移植物失功的风险增加 3.8 倍。