Lim Andy K H, Kansal Arushi, Kanellis John
Department of Nephrology, Monash Health, Clayton, Victoria, 3168, Australia.
Department of Medicine, Monash University, Clayton, Victoria, 3168, Australia.
BMC Nephrol. 2018 Oct 5;19(1):252. doi: 10.1186/s12882-018-1054-7.
Anaemia after kidney transplantation may reduce quality of life, graft or patient survival. We aimed to determine the prevalence and risk factors for anaemia in the initial 12 months after transplantation.
We conducted a cross-sectional study at 6 and 12 months after transplantation. Anaemia was defined by World Health Organization criteria taking into consideration erythropoietin use. Logistic regression was used to determine the association between demographic, clinical and pharmacological risk factors for the main outcome of moderate-severe anaemia.
A total of 336 transplant recipients were included and the prevalence of moderate-severe anaemia was 27.4% at 6 months and 15.2% at 12 months. Lower kidney function, female gender, transferrin saturation below 10% and proteinuria were associated with moderate-severe anaemia at both time points. Recent intravenous immunoglobulin treatment was associated with anaemia at 6 months. Recent infection and acute rejection were also associated with anaemia 12 months. Around 20% of patients had at least one blood transfusion but they were uncommon beyond 3 months.
Anaemia remains highly prevalent requiring treatment with erythropoietin and transfusions. Most identifiable risk factors relate to clinical problems rather than pharmacological management, while markers of iron-deficiency remain difficult to interpret in this setting.
肾移植后贫血可能会降低生活质量、影响移植物或患者的存活。我们旨在确定移植后最初12个月内贫血的患病率及危险因素。
我们在移植后6个月和12个月进行了一项横断面研究。根据世界卫生组织标准并考虑促红细胞生成素的使用情况来定义贫血。采用逻辑回归分析来确定人口统计学、临床和药理学危险因素与中重度贫血这一主要结局之间的关联。
共纳入336例移植受者，中重度贫血的患病率在6个月时为27.4%，在12个月时为15.2%。在两个时间点，较低的肾功能、女性性别、转铁蛋白饱和度低于10%和蛋白尿均与中重度贫血相关。近期静脉注射免疫球蛋白治疗与6个月时的贫血相关。近期感染和急性排斥反应也与12个月时的贫血相关。约20%的患者至少接受过一次输血，但3个月后输血情况并不常见。
贫血仍然非常普遍，需要用促红细胞生成素和输血进行治疗。大多数可识别的危险因素与临床问题而非药物治疗管理有关，而缺铁标志物在这种情况下仍难以解读。
