Al-Otaibi Torki, Gheith Osama, Halim Medhat A, Abu Attia Hasanein, Mansour Hani, Said Tarek, Nair Prasad, Balaha Mohamed, Nampoory M R Narayanan
Hamed Al-Essa Organ Transplant Center, Ibn-Sinah Hospital, Sabah Area, Ministry of Health, Kuwait.
Exp Clin Transplant. 2014 Jun;12(3):220-6.
Posttransplant anemia is associated with an increased risk of congestive heart failure, left ventricular hypertrophy, and death. The purpose of this study was to evaluate the effect of long-acting erythropoietin-stimulating agents on anemia after kidney transplant.
In 2306 kidney transplant recipients, 250 anemic patients (11%) with stable graft function were followed at the Hamed Al-Essa Organ Transplant Centre (Kuwait) and were assessed for anemia. We enrolled 120 patients into this open-label study in 2 groups: group 1 had treatment with darbepoetin alfa (86 patients) and group 2 had continuous erythropoietin receptor activator (34 patients).
Patient age correlated negatively with serum iron level. Serum ferritin correlated negatively with hemoglobin level 6 months after transplant but not at time of transplant. Most patients were women who received their grafts from male donors. The 2 groups were comparable in frequency of rejection and mean hemoglobin and serum albumin levels at 3, 6, 9, and 12 months after transplant. There was no difference between the 2 groups in renal function (estimated glomerular filtration rate); posttransplant complications such as new-onset diabetes after transplant, hypertension, serious bacterial infections, or patient and graft outcomes.
Anemia is an important problem after kidney transplant, and iron use is suboptimal in kidney transplant recipients. Darbepoetin alfa and continuous erythropoietin receptor activator had comparable positive results.
移植后贫血与充血性心力衰竭、左心室肥厚及死亡风险增加相关。本研究旨在评估长效促红细胞生成素刺激剂对肾移植后贫血的影响。
在2306例肾移植受者中，250例（11%）移植肾功能稳定的贫血患者在科威特哈米德·阿勒埃萨器官移植中心接受随访并评估贫血情况。我们将120例患者纳入这项开放标签研究，分为2组：第1组接受聚乙二醇化促红细胞生成素α治疗（86例患者），第2组接受持续促红细胞生成素受体激活剂治疗（34例患者）。
患者年龄与血清铁水平呈负相关。移植后6个月时血清铁蛋白与血红蛋白水平呈负相关，但移植时无此相关性。大多数患者为女性，接受的是男性供者的移植物。两组在移植后3、6、9和12个月时的排斥反应频率、平均血红蛋白和血清白蛋白水平相当。两组在肾功能（估计肾小球滤过率）、移植后新发糖尿病、高血压、严重细菌感染等移植后并发症或患者及移植物结局方面无差异。
贫血是肾移植后的一个重要问题，肾移植受者的铁使用情况欠佳。聚乙二醇化促红细胞生成素α和持续促红细胞生成素受体激活剂取得了相当的阳性结果。
