Valérie Garrigue1, Ilan Szwarc, Magali Giral, Jean-Paul Soulillou, Christophe Legendre, Henri Kreis, Michele Kessler, Marc Ladrière, Nassim Kamar, Lionel Rostaing, Emmanuel Morelon, Fanny Buron, Pascal Daguin, Georges Mourad. 1. 1 Service de Néphrologie, CHU Lapeyronie, Université de Montpellier, Montpellier, France. 2 Institut de Transplantation et de Recherche en Transplantation, CHU Nantes, RTRS « Centaure », et Inserm U1064, Université de Nantes, Nantes, France. 3 Service de Transplantation Rénale et de Soins Intensifs, Hôpital Necker, Paris, France. 4 Universités Paris Descartes et Sorbonne Paris Cité, Paris, France. 5 Service de Néphrologie et Transplantation Rénale, CHU Brabois, Nancy, France. 6 Service de Néphrologie, HTA, Dialyse et Transplantation d'Organes, CHU Rangueil, Toulouse, France. 7 Université Paul Sabatier, Toulouse, France. 8 Service de Néphrologie, Transplantation et Immunologie Clinique, Hôpital Edouard Herriot, Lyon, France. 9 Address correspondence to: Georges Mourad, M.D., Service de Néphrologie, Dialyse et Transplantation, Hôpital Lapeyronie, University of Montpellier, Montpellier 05, France.
Abstract
BACKGROUND AND OBJECTIVES: Contradictory results are reported concerning the influence of anemia on patient and graft survival after renal transplantation. Assuming that level of renal function and anemia are strongly correlated, posttransplantation anemia (PTA) may have a different impact depending on the stage of chronic kidney disease (CKD). METHODS: This study is a retrospective multicenter analysis using the DIVAT French database. The prevalence, risk factors, and influence of 12-month PTA (World Health Organization's definition) on patient and graft survival were analyzed according to CKD stage (Modification of Diet in Renal Disease equation). RESULTS: The prevalence of 12-month PTA in our cohort of 4217 patients was 41.1%. Multivariate analysis demonstrated that worse renal function, donor age, period of transplantation, induction therapy, and mTOR inhibitors were significant risk factors for PTA. Posttransplantation anemia was a significant risk factor for all-cause mortality in CKD stages 1 to 2T (hazard ratio, 2.39; 95% confidence interval, 1.99-4.40) and 3T (hazard ratio, 1.52; 95% confidence interval, 1.08-2.15) and for cardiovascular mortality only on CKD stages 1T and 2T. In renal transplant recipients with CKD stages 4 to 5T, patient and graft survival were similar in patients with versus without anemia. Graft survival was not influenced by PTA, whatever the CKD stage. CONCLUSIONS: Posttransplantation anemia is associated with decreased patient survival only in CKD stages 1T, 2T, and 3T. Posttransplantation anemia has no influence on graft survival regardless of CKD stage.
BACKGROUND AND OBJECTIVES: Contradictory results are reported concerning the influence of anemia on patient and graft survival after renal transplantation. Assuming that level of renal function and anemia are strongly correlated, posttransplantation anemia (PTA) may have a different impact depending on the stage of chronic kidney disease (CKD). METHODS: This study is a retrospective multicenter analysis using the DIVAT French database. The prevalence, risk factors, and influence of 12-month PTA (World Health Organization's definition) on patient and graft survival were analyzed according to CKD stage (Modification of Diet in Renal Disease equation). RESULTS: The prevalence of 12-month PTA in our cohort of 4217 patients was 41.1%. Multivariate analysis demonstrated that worse renal function, donor age, period of transplantation, induction therapy, and mTOR inhibitors were significant risk factors for PTA. Posttransplantation anemia was a significant risk factor for all-cause mortality in CKD stages 1 to 2T (hazard ratio, 2.39; 95% confidence interval, 1.99-4.40) and 3T (hazard ratio, 1.52; 95% confidence interval, 1.08-2.15) and for cardiovascular mortality only on CKD stages 1T and 2T. In renal transplant recipients with CKD stages 4 to 5T, patient and graft survival were similar in patients with versus without anemia. Graft survival was not influenced by PTA, whatever the CKD stage. CONCLUSIONS:Posttransplantation anemia is associated with decreased patient survival only in CKD stages 1T, 2T, and 3T. Posttransplantation anemia has no influence on graft survival regardless of CKD stage.
Authors: David J Taber; Zemin Su; James N Fleming; Nicole A Pilch; Thomas Morinelli; Patrick Mauldin; Derek Dubay Journal: Transpl Int Date: 2018-09-16 Impact factor: 3.782
Authors: Zhongli Huang; Turun Song; Lei Fu; Zhengsheng Rao; Dongyang Zeng; Yang Qiu; Xianding Wang; Libo Xie; Qiang Wei; Li Wang; Tao Lin Journal: Int Urol Nephrol Date: 2015-08-06 Impact factor: 2.370