Impact of very early high doses of recombinant erythropoietin on anemia and allograft function in de novo kidney-transplant patients

Transpl Int. 2010 Mar 1;23(3):277-84. doi: 10.1111/j.1432-2277.2009.00982.x. Epub 2009 Oct 9.

Abstract

After kidney transplantation, occurrence of anemia in the early post-transplant period (<1 month) is high and arises out of issues that are multifactorial. We performed a retrospective single-center study to assess whether delivery of high doses of erythropoietin-stimulating agents (ESA) within the first week of kidney transplantation, translates at 1 month post-transplant, in to causing less anemia and whether it has an impact on allograft function. Ninety-nine patients were not given ESA (group I), whereas 82 were (250 IU/kg/week; group II). All patients had similar pretransplant and baseline (day 0) variables. Similar numbers of group II patients were still receiving ESA by day 14 (97.5%) and day 30 (89%). Respective figures for group I were 27% and 27%. Independent factors for anemia at 1 month post-transplant included: being male subject, treatment for hypertension at pretransplant, anemia at transplant, a higher mean corpuscular volume at transplant, and an induction therapy using antithymocyte globulins. Independent predictive factors for lower creatinine clearance included being female subjects, having a donor aged >50 years, being a recipient aged >50 years, not treated for hypertension at pretransplant, and no post-transplant ESA therapy. High doses of ESA within the first month of kidney transplantation have no impact on anemia or renal function by 1 month post-transplant.

MeSH terms

  • Adult
  • Anemia / blood
  • Anemia / etiology
  • Anemia / prevention & control*
  • Creatinine / blood
  • Erythropoietin / administration & dosage*
  • Female
  • Graft Survival / drug effects
  • Hematinics / administration & dosage*
  • Hemoglobins / metabolism
  • Humans
  • Kidney / drug effects
  • Kidney / physiopathology
  • Kidney Transplantation* / adverse effects
  • Kidney Transplantation* / physiology
  • Male
  • Middle Aged
  • Recombinant Proteins
  • Retrospective Studies
  • Risk Factors
  • Time Factors

Substances

  • Hematinics
  • Hemoglobins
  • Recombinant Proteins
  • Erythropoietin
  • Creatinine