Anemia in children following renal transplantation-results from the ESPN/ERA-EDTA Registry

Background Our aim was to determine the prevalence of sub-target hemoglobin (Hb) levels in children with a renal allograft and to identify potential determinants associated with these Hb levels. Methods Data from 3669 children with a functioning renal allograft, aged Results According to the NKF/KDOQI classification and the UK-NICE guidelines, 49.8 and 7.8 % of the patients, respectively, were anemic. Hb levels were strongly associated with graft function, with Hb levels of 12.6 g/dl in children with chronic kidney disease (CKD) stage 1, declining to 10.7 g/dl in children with CKD stage 5 (P < 0.001). Higher Hb levels were associated with the use of tacrolimus compared to ciclosporin (0.14 g/dl; 95 % confidence interval 0.02-0.27; P = 0.002). Low Hb levels were associated with an increased risk of graft failure (P = 0.01) or combined graft failure and death (P < 0.01), but not with death alone (not significant). Conclusions Anemia is present in a significant proportion of European pediatric kidney transplant recipients and is associated with renal allograft dysfunction and type of immunosuppressants used. In our patient cohort, higher Hb levels were associated with better graft and patient survival and less hypertension.
Author(s): Leah A. Krischock[sup.1] , Karlijn J. van Stralen[sup.2] , Enrico Verrina[sup.3] , E. Jane Tizard[sup.4] , Marjolein Bonthuis[sup.2] , Gyorgy Reusz[sup.5] , Farida K Hussain[sup.6] , Augustina Jankauskiene[sup.7] , [...]