Comparative effects of sirolimus and mycophenolate mofetil on erythropoiesis in kidney transplant patients

Am J Transplant. 2004 Dec;4(12):2001-6. doi: 10.1111/j.1600-6143.2004.00612.x.

Abstract

Anemia and erythrocytosis (PTE) are common after kidney transplantation. We sought to determine the influence of sirolimus compared to mycophenolate mofetil (MMF) on post-transplant erythropoiesis. A total of 214 patients with recent kidney or kidney-pancreas transplants were treated with either sirolimus-based (n = 87) or MMF-based (n = 127) therapy. At 12 months, the prevalence of anemia was 31% with MMF and 57% with sirolimus (p < 0.001). Linear regression was used to examine the independent influence of sirolimus on hemoglobin at 12 months, controlling for multiple factors including gender and renal function. Sirolimus remained a significant correlate of lower hemoglobin in all patients (slope =-1.060, 95% CI: -1.76 to -0.362, p = 0.003), and in patients without PTE (slope =-0.671, 95% CI: -1.32 to -0.028, p = 0.041). PTE, defined as a persistent hematocrit above 51%, occurred in 19% with MMF and 7% with sirolimus (p = 0.013). PTE was examined using logistic regression analysis. Sirolimus use correlated negatively with PTE (odds ratio with sirolimus = 0.33, 95% CI: 0.12 to 0.89, p = 0.028). Our results indicate that, compared to treatment with MMF, treatment of kidney or kidney-pancreas recipients with sirolimus is associated with a higher prevalence of anemia, lower hemoglobin levels and lower incidence of PTE.

Publication types

  • Clinical Trial
  • Comparative Study
  • Controlled Clinical Trial

MeSH terms

  • Anemia / etiology*
  • Anemia / prevention & control
  • Continental Population Groups
  • Erythropoiesis / drug effects*
  • Female
  • Graft Rejection / epidemiology
  • Hematocrit
  • Hemoglobins / metabolism
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Kidney Function Tests
  • Kidney Transplantation / adverse effects*
  • Kidney Transplantation / immunology
  • Kidney Transplantation / physiology*
  • Living Donors
  • Male
  • Middle Aged
  • Tissue Donors

Substances

  • Hemoglobins
  • Immunosuppressive Agents