Kidney

Wednesday September 16, 2020 from

Room: E-Poster Hall

P-11.185 Factors associated with post-transplant anemia in Colombian population with kidney transplant between 2007-2015: A case control study

EYNER LOZANO, Colombia

PROFESSOR
MORFOLOGIA
UNIVERSIDAD NACIONAL DE COLOMBIA

Abstract

Factors associated with post-transplant anemia in Colombian population with kidney transplant between 2007-2015: A case control study

Eyner Lozano1, David Jaramillo1, Juliana Gallego1, Silvia Perez1, Alejandro Isa1, Shirley Nataly Iza1.

1Morfologia Facultad De Medicina, Universidad Nacional De Colombia, Bogota, Colombia

LineaI de trasplantes facultad de medicina universidad nacional de Colombia.

Introduction and Objectives: Anemia in post-renal transplant patients is a frequent complication which can result in increase of cardiovascular morbidities and graft loss. We studied factors associated with the main risk factors associated with post-transplant anemia in colombian population. 
Materials and Methods: A retrospective observational multi-centric case control study was performed. A total of 111 colombian patients with first-time kidney transplant between 2007-2015 were included. Hemoglobin concentration before and after transplantation at day 7, month 1, month 6, year 1 and 2 were measured. The Odds ratio (OR) for each variable was calculated through multiple logistic regression.  
Results: The prevalence of anemia after 6 months was 22%, and after 12 months 14%. Patients with anemia at 6 and 12 months presented a higher incidence of graft loss (p<0.05). 
No significant statistical correlation was found between the use of immunosuppressive agents or Renin/Angiotensin/Aldosterone system inhibitors and post-trasplant anemia (p>0.05). 
Time in hemodialysis had a strong correlation with PTA at month 6 (p<0.05).
Conclusion: Post-transplant anemia showed a strong correlation with renal function. Additionally, hemodialysis time is a predictor factor for PTA. We emphasize the importance of prompt transplantation and a rigorous surveillance of hemoglobin concentration, and administration of erythropoietin stimulating agents if necessary. No significant statistical correlation was found between the use of immunosuppressants or Renin/Angiotensin/Aldosterone system inhibitors and post-trasplant anemia.

References:

[1] 1. Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H, et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet (London, England) [Internet]. Elsevier; 2012 Dec 15 [cited 2018 Nov 27];380(9859):2224–60. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23245609
[2] 2. Instituto nacional de salud. Cuenta de alto costo. Situación del trasplante renal en Colombia.2015
[3] 3. Fondo colombiano de enfermedades de alto costo. Boletín Especial: 2007 - 2017 Cuenta de Alto Costo, 10 años sumando esfuerzos [Internet].Cuentadealtocosto.org. 2018 [cited 27 November 2018]. Available from: https://cuentadealtocosto.org/site/index.php/8-boletines/122-boletin-especial-2007-2017-cuenta-de-alto-costo-10-anos-sumando-esfuerzos/
[4] 4. C Fondo colombiano de enfermedades de alto costo. Boletín Especial: 2007 - 2017 Cuenta de Alto Costo, 10 años sumando esfuerzos [Internet].Cuentadealtocosto.org. 2018 [cited 27 November 2018]. Available from: https://cuentadealtocosto.org/site/index.php/8-boletines/122-boletin-especial-2007-2017-cuenta-de-alto-costo-10-anos-sumando-esfuerzos/
[5] 5. Zadražil J, Horák P, Horčička V, Zahálková J, Štrébl P, Hrubý M. Endogenous erythropoietin levels and anemia in long-term renal transplant recipients. Kidney Blood Press Res. 2007;30(2):108–16
[6] 6. Lorenz M, Kletzmayr J, Perschl A, Sunder-plassmann G, Furrer A, Ho WH. Anemia and Iron Deficiencies among Long-Term Renal Transplant Recipients. 2002;794–7
[7] 7. Montanaro, D et col. Anemia after renal transplantation. G Ital Nefrol 24(1):13–22. 2007
[8] 8. Unal A, Sipahioglu MH, Akcakaya M, Tokgoz B, Sav T, Oymak O, et al. An Underappreciated Problem in Renal Transplant Recipients : Anemia. 2008
[9] 9. Shah N, Al-khoury S, Afzali B, Covic A, Roche A, Marsh J. Posttransplantation Anemia in Adult Renal Allograft Recipients : Prevalence and Predictors. 2006;81(8):1112–8
[10] 10. Vanrenterghem Y, Ponticelli C, Morales M, Abramowicz D, Legendre C, Morais AL, et al. Prevalence and Management of Anemia in Renal Transplant Recipients : A European Survey. 2003;835–45.
[11] 11. Chhabra D, Grafals M, Skaro AI, Parker M, Gallon L, Carolina N. Impact of Anemia after Renal Transplantation on Patient and Graft Survival and on Rate of Acute Rejection. 2008;1168–74.
[12] 12. Winkelmayer WC, Chandraker A. Posttransplantation Anemia : Management and Rationale Course of Anemia after Transplantation. 2008;49–55.
[13] 13. Chadban SJ, Baines L, Polkinghorne K. Anemia after kidney transplantation is not completely Explained by Reduced Kidney Function. 2007;49(2):301–9
[14] 14. Blosser CD, Bloom RD. Posttransplant anemia in solid organ recipients. Transplant Rev [Internet]. Elsevier Inc.; 2010;24(2):89–98. Available from: http://dx.doi.org/10.1016/j.trre.2010.01.006
[15] 15. Molnar MZ, Czira M, Ambrus C. Anemia Is Associated with Mortality in Kidney-Transplanted Patients.A Prospective Cohort Study. 2007;(17):818–24.
[16] 16. Majernikova M, Rosenberger J, Prihodova L, Jarcuskova M, Roland R, Groothoff JW, et al. Posttransplant Anemia as a Prognostic Factor of Mortality in Kidney-Transplant Recipients. 2017;2017:8–1
[17] 17. Afzali B, Al-Khoury S, Shah N, Mikhail A, Covic A, Goldsmith D. Anemia after renal transplantation. 2006;48(4):519–36
[18] 18. Kamar N, Rostaing L, Ignace S, Impact VE. Impact of post-transplant anemia on patient and graft survival rates after kidney transplantation : a meta-analysis. 2011;1–9
[19] 19. Maria C, Oliveira C, Sátiro P, Ii T, Roque S, Ii P, et al. Post-transplant anemia and associated risk factors : the impact of steroid-free therapy. 2013;131(6):369–76
[20] 20. Shibagaki Y, Shetty A. Anaemia is common after kidney transplantation , especially among African Americans. 2004;19(9):2368–73
[21] 21. Yorgin PD, Scandling JD, Andreoni KA, Yorgin PD. Late Post-transplant Anemia in Adult Renal Transplant Recipients . An Under-recognized Problem ? 2002;429–35
[22] 22. Lim AKH, Kansal A, Kanellis J. Factors associated with anaemia in kidney transplant recipients in the first year after transplantation : a cross-sectional study. BMC Nephrology; 2018;1–10.
[23] 23. Munksgaard B, Mix TCH, Kazmi W, Ruthazer R, Rohrer R, Pereira JG, et al. Anemia : A Continuing Problem Following Kidney Transplantation. 2003;1426–33.
[24] 24. Palomar R, Rodrigo E, Ruiz JC, Cotorruelo JG, Arias M. Prevalence of Anemia in Renal Transplant Patients : Results From MOST , an Observational Trial. 2005;3822:3821–2
[25] 25. Marcén R, Galeano C, Jiménez S, Teruel JL, Burgos FJ, Quereda C. Anemia at 1 Year After Kidney Transplantation Has a Negative Long- term Impact on Graft and Patient Outcomes. TPS [Internet]. Elsevier Inc.; 2012;44(9):2593–5. Available from: http://dx.doi.org/10.1016/j.transproceed.2012.09.033
[26] 26. Molnar MZ, Krishnan M, Nissenson AR, Kalantar-zadeh K. Associations of Pretransplant Serum Albumin with Post-Transplant Outcomes in Kidney Transplant. 2011;(12):1006–15.
[27] 27. Wang K, Zhang H, Li Y, Wei Q, Li H, Yang Y, et al. Safety of Mycophenolate Mofetil Versus Azathioprine in Renal Transplantation: A Systematic Review. 2004;2070:2068–70.
[28] 28. Weir MR. Original Report : Specific Management of Anemia and Hypertension in Renal Transplant Recipients : Influence of Renin-Angiotensin System Blockade. 2014;1–7.
[29] 29. Slavickova R, Lanska V, Stollova M, Viklicky O. Prevalence of late posttrasplant anemia in adult kidney trasplant recipients and the role of Sirolimus – A single centre study. 2010;90(2):2634.
[30] 30. Bren A, Arnol M, Kandus A, Varl J, Oblak M, Lindic J, et al. Treatment of Anemia With Epoetin in Kidney Transplant Recipients. 2011;15(3):257–60
[31] 31. KDOQI; National Kidney Foundation Clinical practice guidelines and clinical practice recommendations for anaemia in chronic kidney disease in adults. 2006;47(5):11–5.
[32] 32. Brown C, Williams JA. Clinical Practice Guideline Anaemia of Chronic Kidney Disease. 2017;(June).

Comments

There are no comments yet...



© 2024 TTS 2020