Anemia is a predictor of graft loss but not cardiovascular events and all‐cause mortality in renal transplant recipients: follow‐up data from the ALERT study. (2nd September 2013)

• Record Type: Journal Article
• Authors: Schjelderup, Patrick; Dahle, Dag Olav; Holdaas, Hallvard; Mjøen, Geir; Nordby, Gudrun; Abedini, Sadollah; Jardine, Alan; Fellström, Bengt; Svensson, My
• Is Part Of: Clinical transplantation. Volume 27:Number 6(2013:Nov./Dec.)
• Page Start: E636
• Page End: E643
• Publication Date: 2013-09-02
• Subjects: Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ctr.12220
• Languages: English
• ISSNs: 0902-0063

Abstract

<abstract abstract-type="main" id="ctr12220-abs-0001"> <title>Abstract</title> <sec id="ctr12220-sec-0001" sec-type="section"> <title>Background</title> <p>It is well established that post‐transplantation anemia (PTA) in renal transplant recipients (RTRs) is associated with reduced graft survival. However, there is an uncertainty of the effect of PTA on cardiovascular events and all‐cause mortality. We examined prospectively in a large cohort of erythropoietin‐naive patients the effects of PTA on cardiovascular morbidity, patient survival, and graft survival.</p> </sec> <sec id="ctr12220-sec-0002" sec-type="section"> <title>Methods</title> <p>A prospective cohort study of RTRs (n = 2102) included in the ALERT study. Cox regression models were used to evaluate the impact of PTA on study endpoints: first occurrence of a major adverse cardiac event, all‐cause death, and the incidence of death‐censored graft loss. Mean follow‐up was 6.7 yr. All endpoints were adjudicated by an independent endpoint committee.</p> </sec> <sec id="ctr12220-sec-0003" sec-type="section"> <title>Results</title> <p>Twenty‐nine percent of women and 30% of men were anemic. Hemoglobin levels were not associated with any effect on cardiovascular morbidity and mortality (HR 0.97 [0.90–1.05] per g/dL, p = 0.48) or all‐cause death (HR 0.96 [0.90–1.03] per g/dL, p = 0.24) after extensive multivariate adjustments for clinical and demographic factors. Hemoglobin levels were negatively associated with graft loss (HR 0.86 [0.80–0.92] per g/dL, p < 0.001).</p> </sec> <sec id="ctr12220-sec-0004" sec-type="section"> <title>Conclusions</title> <p>PTA was not associated with an increased incidence of cardiovascular morbidity and mortality or all‐cause mortality.</p> </sec> </abstract>