Gafter-Gvili Anat, Ayalon-Dangur Irit, Cooper Lisa, Shochat Tzippy, Rahamimov Ruth, Gafter Uzi, Mor Eytan, Grossman Alon
Department of Medicine A, Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel Department of Medicine E, Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel Department of Geriatrics, Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel Bio-Statistical Unit, Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel Department of Nephrology and Hypertension, Rabin Medical Center, Petah Tikva, Israel Department of Transplantation, Rabin Medical Center, Beilinson Campus, Israel.
Medicine (Baltimore). 2017 Aug;96(32):e7735. doi: 10.1097/MD.0000000000007735.
We sought to assess the frequency and predictors of early and late posttransplantation anemia (PTA). In addition, we aimed to assess the outcomes of patients with anemia and to assess the impact of anemia on mortality, graft function, and graft failure.Patients who underwent kidney transplantation in a single center during a 4-year period were included. Predictors associated with the development of anemia at 6 months (early PTA) or 2 years (late PTA) were evaluated in a univariate and multivariate analyses. The effects of anemia and other variables on mortality and graft function were assessed.A total of 266 kidney transplant recipients were included. The prevalence of PTA at 6 months (early PTA) was 51.3% and at 2 years (late PTA) was 36.6%. Female sex was significantly associated with early PTA. Patients with early PTA proceeded to late PTA. Patients with both early and late PTA had a higher mortality rate at 4 years compared to patients without anemia. On multivariable analysis, lower Hb at 2 years posttransplantation (hazard ratio [HR] 0.716, 95% confidence intervals [CI] 0.541-0.948, for every increment of 1 g/dL) was significantly associated with mortality. Patients with late PTA suffered a decline in eGFR compared to patients without anemia (P = .026). Furthermore, a lower Hb at 2 years posttransplantation was also associated with graft failure (HR 0.775, 95% CI 0.619-0.969, for every increment of 1 g/dL).Post-transplantation anemia is significantly associated with late mortality, with a decline in graft function and with an increased incidence of graft failure.
我们试图评估肾移植术后早期和晚期贫血（PTA）的发生率及预测因素。此外，我们旨在评估贫血患者的预后，并评估贫血对死亡率、移植肾功能及移植失败的影响。纳入了在4年期间于单一中心接受肾移植的患者。在单因素和多因素分析中评估了与术后6个月（早期PTA）或2年（晚期PTA）贫血发生相关的预测因素。评估了贫血及其他变量对死亡率和移植肾功能的影响。
共纳入266例肾移植受者。术后6个月（早期PTA）的PTA发生率为51.3%，术后2年（晚期PTA）为36.6%。女性与早期PTA显著相关。早期PTA患者会发展为晚期PTA。与无贫血患者相比，早期和晚期均发生PTA的患者在4年时死亡率更高。多因素分析显示，移植后2年时较低的血红蛋白水平（风险比[HR] 0.716，95%置信区间[CI] 0.541 - 0.948，每增加1 g/dL）与死亡率显著相关。与无贫血患者相比，晚期PTA患者的估算肾小球滤过率（eGFR）下降（P = 0.026）。此外，移植后2年时较低的血红蛋白水平也与移植失败相关（HR 0.775，95% CI 0.619 - 0.969，每增加1 g/dL）。
肾移植术后贫血与晚期死亡率显著相关，伴有移植肾功能下降及移植失败发生率增加。
