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Saudi Journal of Kidney Diseases and Transplantation
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Year : 2013  |  Volume : 24  |  Issue : 2  |  Page : 366-367
The risk factors of anemia after kidney transplantation

Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Baqiyatallah Hospital, Tehran, Iran

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Date of Web Publication26-Mar-2013

How to cite this article:
Rostami Z, Einollahi B. The risk factors of anemia after kidney transplantation. Saudi J Kidney Dis Transpl 2013;24:366-7

How to cite this URL:
Rostami Z, Einollahi B. The risk factors of anemia after kidney transplantation. Saudi J Kidney Dis Transpl [serial online] 2013 [cited 2020 Feb 17];24:366-7. Available from: http://www.sjkdt.org/text.asp?2013/24/2/366/109605
To the Editor,

We read with great interest the article entitled "Prevalence and association of post-renal transplant anemia" by Elsayed et al, which was recently published in your esteemed journal. [1] Anemia is quite a prevalent complication after kidney transplanation. Despite the techincal and medical improvement, there are still so many concerns about this complication. Elsayed et al in a retrospective study focused on the prevalence of anemia and its risk factors among 200 renal transplant recipients (RTRs). In this study, the prevalence of anemia was 45% at six months after transplantation, and they demonstrated that high serum creatinine level, female gender, delayed graft function, acute rejection, and infection were the only independent risk factors for anemia in RTRs. [1] Similarly, we found a high prevalence of post-transplantation anemia (PTA; 53%) among 2713 adult RTRs, and the prevalence of severe anemia according to the World Health Organization criteria was 24%. [2] In our survey, however, the impaired renal function was the only risk factor associated with anemia. [2] In another large cohort study, which enrolled 864 adult subjects, severe anemia immediately after kidney transplantation was 62.7%, which was significantly associated with donor age, recipient female gender, and anti-thymocyte globulin (ATG)/antilymphocyte globulin (ALG) administration. [3]

We agree that although erythropoiesis returns to normal level a few hours after good functioning of allograft [3] and also new erythtropoeitin stimulating agents provide a good support to early treatment of anemia after transplantation, several factors such as iron deficiency, blood loss, immunosuppressive drugs, bone marrow suppression due to hyperparathyroidism, and other conditions may hinder the improvement of anemia. As Elsayed et al [1] mentioned, however, anemia after kidney transplantation can seriously affect the graft function and predispose patients to cardiovascular events; [4] hence, anemia increases mortality and morbidity in these patients. For this reason, several studies have been done until now to distinguish the risk factors [2],[3],[5],[6] for prevention and treatment of anemia after kidney transplantation. For decision making, we need to research with greater sample size, different age groups, and different periods after operation.

Furthermore, the studies conducted varied in the age groups studied and anemia could be dependent on different risk factors. For example, prevalence of severe anemia in 214 elderly RTRs one year after transplantation was 7.9%, and only renal dysfunction was associated with a high probability of late anemia. [5] While in another study, among 78 pediatric RTRs, the prevalence of PTA was 15.4%; similarly renal allograft impairment was the only risk factor for late anemia. [6]

We suggest further studies to be conducted on different races and with different contributing factors, which require preparing clear guidelines to help better problem solving.

   References Top

1.Elsayed H, Sany D, Eldin EN, El-shahawy Y, Shawki S, Aziz A. Prevalence and association of post-renal transplant anemia. Saudi J Kidney Dis Transpl 2012;23:461-6.  Back to cited text no. 1
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2.Einollahi B, Lessan-Pezeshki M, Rostami Z, Kalantar E, Afshar R, Beiraghdar F. Anemia after kidney transplantation in adult recipients: Prevalence and risk factors. Transplant Proc 2011;43:578-80.  Back to cited text no. 2
3.Rostami Z, Shafighi N, Baghersad MM, Einollahi B. Risk factors for immediate anemia in renal transplant recipients: A single-center experience. Transplant Proc 2011;43:581-3.  Back to cited text no. 3
4.Chhabra D, Grafals M, Skaro AI, Parker M, Gallon L. Impact of anemia after renal transplantation on patient and graft survival and on rate of acute rejection. Clin J Am Soc Nephrol 2008;3:1168-74.  Back to cited text no. 4
5.Rostami Z, Einollahi B, Teimoori M. Prevalence of Anemia in Elderly Patients One Year After Renal Transplantation. Nephrol-Urol Mon 2012;4:361-5.   Back to cited text no. 5
6. Einollahi B, Rostami Z, Teimoori M, Bieraghdar F. Late anemia in pediatric kidney transplant recipients: Prevalence and risk factors. Nephrol-Urol Mon 2011;3:172-6.  Back to cited text no. 6

Correspondence Address:
Zohreh Rostami
Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Baqiyatallah Hospital, Tehran
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DOI: 10.4103/1319-2442.109605

PMID: 23538366

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