Increasing incidence of post-kidney transplant anemia in children

Am J Transplant. 2005 Jul;5(7):1713-8. doi: 10.1111/j.1600-6143.2005.00919.x.

Abstract

Anemia status at 1-year post-kidney transplant was documented retrospectively in 231 pediatric recipients (mean age: 12.6 +/- 5.0, range: 1.9-20.7 years) at Cincinnati Children's Hospital Medical Center between 1978 and 2003. Anemia was present in 59 (25.5%) patients. The prevalence of anemia has increased in the more recent eras (1978-1985: 7.8%, 1986-1997: 29%; 1998-2003: 32%, p < 0.01). Logistic regression analysis determined that the use of calcineurin inhibitors or impaired allograft function predicted anemia at 1-year post-transplant. Kaplan-Meier analysis showed that children with anemia at 1-year post-transplant had a significantly worse overall allograft survival than children without anemia (p = 0.02). However, when data were analyzed using a Cox proportional hazards model, only lower allograft function at 1-year post-transplant, black race and older era, but not anemia, independently predicted worse graft survival in children. This study suggests that the recent increase in the incidence of anemia post-kidney transplant is related to modern immunosuppressive therapy and that post-transplant anemia is more likely a marker of allograft dysfunction in children rather than its cause.

MeSH terms

  • Adolescent
  • Adult
  • African Continental Ancestry Group
  • Anemia / epidemiology*
  • Anemia / etiology*
  • Calcineurin Inhibitors
  • Child
  • Child, Preschool
  • Cohort Studies
  • Female
  • Graft Survival
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Incidence
  • Infant
  • Kidney / physiopathology
  • Kidney Transplantation / adverse effects*
  • Logistic Models
  • Male
  • Proportional Hazards Models
  • Retrospective Studies
  • Transplantation, Homologous

Substances

  • Calcineurin Inhibitors
  • Immunosuppressive Agents