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Saudi Journal of Kidney Diseases and Transplantation
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LETTER TO THE EDITOR  
Year : 2016  |  Volume : 27  |  Issue : 1  |  Page : 172-173
Renal transplantation erythrocytosis among recipients of kidney transplantation of Afro-Arab origin patients


1 Department of Nephrology, Gezira Hospital for Kidney Diseases and Surgery, Wad Medani, Gezira State, Sudan
2 Gezira University, Wad Medani, Gezira State, Sudan

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Date of Web Publication15-Jan-2016
 

How to cite this article:
Elhafiz EM, Ahmed Abu Alga SA, Gibreel AA. Renal transplantation erythrocytosis among recipients of kidney transplantation of Afro-Arab origin patients. Saudi J Kidney Dis Transpl 2016;27:172-3

How to cite this URL:
Elhafiz EM, Ahmed Abu Alga SA, Gibreel AA. Renal transplantation erythrocytosis among recipients of kidney transplantation of Afro-Arab origin patients. Saudi J Kidney Dis Transpl [serial online] 2016 [cited 2021 Aug 2];27:172-3. Available from: https://www.sjkdt.org/text.asp?2016/27/1/172/174207
To the Editor,

Post-transplant erythrocytosis (PTE) is defined as persistently elevated hemoglobin and hematocrit levels that sustain for more than six months without the presence of leukocytosis, thrombocytosis or another potential cause of erythrocytosis after renal transplantation. [1],[2],[3],[4],[5] The prevalence of PTE is 8-15% of renal transplant recipients. [1],[2],[3],[4] The Black population is believed to have a lower renin activity than the white population. [6] The rennin-angiotensin system can induce the hypoxia-inducible factor and promotes the production of erythropoietin and PTE. [7]

We report the prevalence of PTE in our patients who received kidney transplantation at our center. We included in the study those patients who received their kidney transplant three months earlier or more and consented for the study. We excluded from the study those patients who suffered from erythrocytosis prior to renal transplantation and who had erythrocytosis due to other causes such as respiratory, cardiovascular diseases and myeloproliferative disorders. The hemoglobin and hematocrit levels were measured for six months.

The study group included 110 patients; 70 (77%) were male. The mean age was 41.43 (SD 11.74) years. The duration of dialysis was 17.5 (±13.67) months. The etiology of chronic kidney disease was unknown in 60% of the patients, with 20% patients had hypertension, 5.5% patients had diabetes mellitus, 5.4% patients had chronic glomerulonephritis and 2.7% patients had obstructive nephropathy. PTE was found in 15 (13.6%) patients; the majority (86.66%) were male, with a M:F ratio of 6.45 to 1 (P-value = 0.130). The mean hemoglobin level in the PTE group was 18.1 ± 0.92 g/dL. Ten percent of the patients in the study group were smokers and three of the 2.7% had PTE.

Thirty percent of the recipients received cyclosporine, and 5.5% of them had PTE (Pvalue = 0.165). Tacrolimus was prescribed in 66.4% of the recipients, and 9.1% of them had PTE (P-value = 0.974). Azathioprine was prescribed in 71.8% patients, and 9.1% of them had PTE (P-value = 0.633). Mycophenolate mofetil was prescribed in 19.1% of patients, and 3.6% of them had PTE (P-value = 0.422). Prednisolone was prescribed in 97.3% of the recipients, and 13.6% of them had PTE (Pvalue = 4.85).

In the present study, we found that the prevalence of PTE among Afro-Arab was consistent with the international data on PTE. [8],[9],[10],[11],[12],[13],[14],[15],[16] Curtis et al reported that PTE was found in 17.3% [8] and Qunibi et al reported that PTE was found in 21.6%, [9] which were higher than our prevalence, although we used the same Hct levels (>51%). This is different from the study carried out by Chien et al, who found PTE in 9.7%, [10] which is lower than the prevalence in our study, although they used a Hct reference lower than our value. None of these studies were conducted in the Afro-Arab population. We could not find any correlation between the immunosuppressive agents and PTE.

We conclude that the prevalence of PTE among Afro-Arab patients is similar to that in the other ethnic groups.

Conflict of interest:

The authors declare that there is no conflict of interests regarding the publication of this article.

 
   References Top

1.
Gaston RS, Julian BA, Curtis JJ. Post-transplant erythrocytosis: An enigma revisited. Am J Kidney Dis 1994;24:1-11.  Back to cited text no. 1
    
2.
Vlahakos DV, Marathias KP, Agroyannis B, Madias NE. Post-transplant erythrocytosis. Kidney Int 2003;63:1187.  Back to cited text no. 2
    
3.
Augustine JJ, Knauss TC, Schulak JA, Bodziak KA, Siegel C, Hricik DE. Comparative effects of sirolimus and mycophenolate mofetil on erythropoiesis in kidney transplant patients. Am J Transplant 2004;4:2001-6.  Back to cited text no. 3
    
4.
Kiberd BA. Post-transplant erythrocytosis: A disappearing phenomenon? Clin Transplant 2009;23:800-6.  Back to cited text no. 4
    
5.
Einollahi B, Lessan-Pezeshki M, Nafar M, et al. Erythrocytosis after renal transplantation: Review of 101 cases. Transplant Proc 2005;37: 3101-2.  Back to cited text no. 5
    
6.
Helmer OM, Judson WE. Metabolic studies on hypertensive patients with suppressed plasma renin activity not due to hyperaldosternism. Circulation 1968;38:965-76.  Back to cited text no. 6
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7.
Richard DE, Berra E, Pouyssegur J. Nonhypoxic pathway mediates the induction of hypoxiainducible factor 1 alpha in vascular smooth muscle cells. J Biol Chem 2000;275:26765-71.  Back to cited text no. 7
    
8.
Curtis GW, Douglas JN, Aice B, John MB, William MB. Post-renal transplant erythrocytosis: A review of 53 patients. Kidney Int 1983;23:731-7.  Back to cited text no. 8
    
9.
Qunibi WY, Barri Y, Devol E, al-Furayh O, Sheth K, Taher S. Factors predictive of post-transplant erythrocytosis. Kidney Int 1991;40: 1153-9.  Back to cited text no. 9
    
10.
Chien HC, Huang CC, Huang JY, Shu CH, Lai MK. Post-renal transplant erythrocytosis. Changgeng Yi Xue Za Zhi 1996;19:235-40.  Back to cited text no. 10
    
11.
Kessler M, Hestin D, Mayeux D, Mertes PM, Renoult E. Factors predisposing to post-renal transplant erythrocytosis. A prospective matchedpair control study. Clin Nephrol 1996;45:83-9.  Back to cited text no. 11
    
12.
Sumarani NB, Daskalakis P, Miles AM, et al. Erythrocytosis after renal transplantation: A prospective analysis ASAIO J 1993;39:51-5.  Back to cited text no. 12
    
13.
Abdarahman M, Rafi A, Ghacha R, Gayyum T, Karkar A. Post-transplant erythrocytosis: A review of 47 renal transplant recipient. Saudi J Kidney Dis Transpl 2004;15:433-9.  Back to cited text no. 13
    
14.
Einollahi B, Lessan PM, Nafar M, et al. Erythrocytosis after renal transplantation: Review of 101 cases. Transplant Proc 2005;37: 3101-2.  Back to cited text no. 14
    
15.
Basri N, Genedo MZ, Haider R, Abdullah KA, Hassan A, Shaheen FA. Post-transplant erythrocytosis in renal transplant recipients at Jeddah Kidney Center, Kingdom of Saudi Arabia. Exp Clin Transplant 2007;5:607-9.  Back to cited text no. 15
    
16.
Charfeddine K, Zaghdane S, Yaich S, Hakim A, Hachicha J. Factors predisposing to post-renal transplant erythrocytosis: A retrospective study. Saudi J Kidney Dis Transpl 2008;19: 371-7.  Back to cited text no. 16
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Correspondence Address:
Dr. Elsharif Mohamed Elhafiz
Department of Nephrology, Gezira Hospital for Kidney Diseases and Surgery, Wad Medani, Gezira State
Sudan
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DOI: 10.4103/1319-2442.174207

PMID: 26787590

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