EVALUATION OF ANEMIA IN RENAL TRANSPLANT PATIENTS
Malak Hussein Muhealdeen a, Safa Ezadin Almukhtar b, Kawa Hussein Ameen c, and Dana Ahmad Sharif c
a Nephrology Board Trainee, Ministry of Health Director of Health, Kurdistan Region, Iraq.
b College of Medicine, Hawler Medical University, Hawler, Kurdistan Region, Iraq.
c College of Medicine, University of Sulaimani, Kurdistan Region, Iraq.
Submitted: 18/5/2021; Accepted: 28/8/2021; Published: 21/6/2022
DOI Link: https://doi.org/10.17656/jsmc.10349
Post-renal transplant anaemia is a common complication among renal transplant patients. Graft dysfunction, medications, and IDA are the most common causes of PTA.
To investigate further the prevalence of anaemia after kidney transplantation in Sulaimani city, determine the risk factors and the association of different socio-demographic characteristics with PTA, and identify the essential causes of anaemia
Patients and Methods
A cross-sectional descriptive study was conducted on two hundred renal transplant patients who visited Shar-hospital in Sulaimani city for their regular follow up between January/ 2020-January/ 2021.
Among the total 200 patients involved in the study, 63% were males, 37% were females, mean age was 45.32±9.28. It demonstrated that PTA was remarkably high (40%). Iron deficiency anaemia is the most common cause of PTA 28.75%, especially in 1st six months after renal transplantation; GFR decline for any reason (rejection, ATN, viral infection) is significantly associated with anaemia; the lower the GFR, the higher number of anaemic patients (p=0.000).
Our findings showed that anaemia is widespread after renal transplantation. Iron deficiency anaemia is the most common cause of anaemia, followed by acute cellular rejection.
Kidney transplant, Anemia, PTA, Haemoglobin, Immunosuppressive treatment.
1. Yabu JM, Winkelmayer WC. Posttransplantation anaemia: mechanisms and management. Clinical Journal of the American Society of Nephrology. 2011 Jul 1;6(7):1794-801.
2. Yorgin PD, Scandling JD, Belson A, Sanchez J, Alexander SR, Andreoni KA. Late post-transplant anaemia in adult renal transplant recipients. An under‐recognized problem? American Journal of Transplantation. 2002 May;2(5):429-35.
3. Schechter A, Gafter-Gvili A, Shepshelovich D, Rahamimov R, Gafter U, Mor E, Chagnac A, Rozen-Zvi B. Post renal transplant anaemia: severity, causes and their association with graft and patient survival. BMC nephrology. 2019 Dec;20(1):1-1.
4. Gafter-Gvili A, Ayalon-Danger I, Cooper L, Shochat T, Rahamimov R, Gafter U, Mor E, Grossman A. Posttransplantation anaemia in kidney transplant recipients: a retrospective cohort study. Medicine. 2017 Aug;96(32).
5. Turkowski-Duhem A, Kamar N, Cointault O, Lavayssiere L, Ribes D, Esposito L, Fillola G, Durand D, Rostaing L. Predictive factors of anaemia within the first-year post-renal transplant. Transplantation. 2005 Oct 15;80(7):903-9.
6. Ott U, Busch M, Steiner T, Wolf G. Anemia after renal transplantation: an underestimated problem. Transplant Proc. 2008 Dec;40(10):3481-4. doi: 10.1016/j.transproceed.2008.07.139. PMID: 19100418.
7. Lozano E, Jaramillo D, Gallego J, Perez S, Isa A, Iza SN. FACTORS ASSOCIATED WITH POST-TRANSPLANT ANEMIA IN COLOMBIAN POPULATION WITH KIDNEY TRANSPLANT BETWEEN 2007-2015: A CASE-CONTROL STUDY. Transplantation. 2020 Sep 1;104(S3): S456-7.
8. Imoagene-Oyedeji AE, Rosas SE, Doyle AM, Goral S, Bloom RD. Posttransplantation anaemia at 12 months in kidney recipients treated with mycophenolate mofetil: risk factors and implications for mortality. Journal of the American Society of Nephrology. 2006 Nov 1;17(11):3240-7.
9. Green R. Vitamin B12 deficiency from the perspective of a practising haematologist. Blood. 2017 May 11;129(19):2603-11.
10. Kidney disease. Improving Global Outcomes (KDIGO) Acute Kidney Injury Work Group. KDIGO clinical practice guideline for acute kidney injury. Kidney Int Suppl. 2012;(2):1–138
11. Talas MS, Bayraktar N. Kidney transplantation: determination of the problems encountered by Turkish patients and their knowledge and practices on healthy living. Journal of clinical nursing. 2004 Jul;13(5):580-8.
12. Elsayed H, Sany D, Eldin EN, El-Shahawy Y, Shawki S, Aziz A. Prevalence and association of post-renal transplant anaemia. Saudi Journal of Kidney Diseases and Transplantation. 2012 May 1;23(3):461.
13. Vanrenterghem Y, Ponticelli C, Morales JM, Abramowicz D, Baboolal K, Eklund B, Kliem V, Legendre C, Morais Sarmento AL, Vincenti F. Prevalence and management of anaemia in renal transplant recipients: a European survey. American Journal of Transplantation. 2003 Jul;3(7):835-45.
14. Turkowski-Duhem A, Kamar N, Cointault O, Lavayssiere L, Ribes D, Esposito L, Fillola G, Durand D, Rostaing L. Predictive factors of anaemia within the first-year post-renal transplant. Transplantation. 2005 Oct 15;80(7):903-9.
15. Afzali B, Al-Khoury S, Shah N, Mikhail A, Covic A, Goldsmith D. Anemia after renal transplantation. Am J Kidney Dis. 2006 Oct;48(4):519-36. doi: 10.1053/j.ajkd.2006.07.006. PMID: 16997048.
16. Winkelmayer WC, Kewalramani R, Rutstein M, Gabardi S, Vonvisger T, Chandraker A. Pharmacoepidemiology of anaemia in kidney transplant recipients. Journal of the American Society of Nephrology. 2004 May 1;15(5):1347-52.
17. Gossmann J, Thürmann P, Bachmann T, Weller S, Kachel HG, Schoeppe W, Scheuermann EH. Mechanism of angiotensin-converting enzyme inhibitor-related anaemia in renal transplant recipients. Kidney international. 1996 Sep 1;50(3):973-8.
18. Montanaro D. L’anemia nel trapiantato di rene [Anemia after renal transplantation]. G Ital Nefrol. 2007 Jan-Feb;24(1):13-22. Italian. PMID: 17342689.
© The Authors, published by University of Sulaimani, College of Medicine
This work is licensed under a Creative Commons Attribution 4.0 International License.