… Life Lies Waiting

Hricik, Donald E.

doi:10.1034/j.1600-6143.2003.00174.x

Cited by 15 publications

(12 citation statements)

References 6 publications

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“…This may explain the high prevalence of anemia despite erythropoietin therapy that we and others have found (16). The underlying inflammation may make some transplant recipients resistant to erythropoietin therapy (24,25). Similarly, animal studies have also suggested a role for immunologic injury in the development of hypertension and endothelial dysfunction after transplantation (26).…”

Section: Discussionmentioning

confidence: 81%

The Burden of Chronic Kidney Disease in Renal Transplant Recipients

Karthikeyan

Karpinski

Nair

et al. 2004

American Journal of Transplantation

135

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The National Kidney Foundation has developed guidelines for the diagnosis and classification of chronic kidney disease (CKD) but it is not known whether these are applicable to renal transplant recipients. This study determined the prevalence of CKD according to the stages defined in the guidelines, the complications related to CKD and whether the prevalence of complications was related to CKD stage in 459 renal transplant recipients. CKD was present in 412 patients (90%) and

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Section: Discussionmentioning

confidence: 81%

The Burden of Chronic Kidney Disease in Renal Transplant Recipients

Karthikeyan

Karpinski

Nair

et al. 2004

American Journal of Transplantation

135

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“…However, an effect of sirolimus on erythrocyte production has been reported, and this correlates with drug dose and blood level. In a recent study of sirolimus with ciclosporin (now not a favoured combination) [26], anaemia was seen in 16% of the patients on 2 mg/day and in 27% of those on 5 mg/day. In particular, the combination of sirolimus and MMF is clearly very potent in causing bone marrow suppression [26].…”

Section: Immunosuppressive Drugsmentioning

confidence: 99%

“…In a recent study of sirolimus with ciclosporin (now not a favoured combination) [26], anaemia was seen in 16% of the patients on 2 mg/day and in 27% of those on 5 mg/day. In particular, the combination of sirolimus and MMF is clearly very potent in causing bone marrow suppression [26]. Kreis et al [27] reported a 43% incidence of anaemia in patients on sirolimus plus MMF as compared with 29% for patients on ciclosporin plus MMF.…”

Section: Immunosuppressive Drugsmentioning

confidence: 99%

Anaemia after Renal Transplantation – Role of Immunosuppressive Drugs and a Pathophysiological Appraisal

et al. 2006

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Improvements in patient care and longevity on dialysis programmes together with the increased numbers of patients referred for renal replacement therapy will inevitably result in enlarging numbers of subjects with functioning renal transplants. While this translates to a boon for the patients in terms of survival and quality of life, a very real problem has begun to emerge, that of post-transplantation anaemia (PTA). The prevalence of this condition has been estimated by several studies as varying somewhere between one third and two thirds of all patients, with the same attendant problems as anaemia in the context of chronic kidney disease. PTA is multifactorial in origin and involves interplay between a number of risk factors, not least of all the immunosuppressive protocol. It is the purpose of this article to briefly review the contribution from transplant immunosuppression to PTA and to assess its likely effects on and treatment options for patients.

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“…PTA has not been defined uniformly in terms of time frame or hemoglobin level after transplantation. Some authors have suggested distinguishing early from late PTA, with the cutoff between the two periods being the 6-mo posttransplantation time point (10,(15)(16)(17)(18). Several risk factors have been associated with PTA, including chronic allograft dysfunction, antiproliferative immunosuppression (e.g., mycophenolate mofetil [MMF], sirolimus), chronic iron deficiency, and renin-angiotensin system blocking therapies (angiotensin-converting enzyme inhibitors [ACEI] and angiotensin II type 1 receptor blockers [ARB]) (10,13,18,19).…”

mentioning

confidence: 99%

Posttransplantation Anemia at 12 Months in Kidney Recipients Treated with Mycophenolate Mofetil

Imoagene-Oyedeji¹,

Rosas²,

Doyle³

et al. 2006

Journal of the American Society of Nephrology

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Although posttransplantation anemia (PTA) is common in the mycophenolate mofetil era, its impact on patient survival is unknown. This retrospective cohort study characterized factors that are associated with PTA 12 mo after transplantation in mycophenolate mofetil-treated kidney recipients and explored whether 12-mo PTA affects outcomes. The records of 626 kidney recipients were examined for presence of anemia (hemoglobin <12 g/dl). Multivariate regression models, fit with covariates that had unadjusted relationships, investigated both risk factors for 12-mo PTA and whether 12-mo PTA contributes to mortality. Anemia prevalence was 72, 40, and 20.3% at 1, 3, and 12 mo, respectively. By multivariate logistic regression, anemia at 3 mo (odds ratio [OR] 10.0; 95% confidence interval [CI] 5.3 to 17.1; P ‫؍‬ 0.0001), donor age (OR 1.0; 95% CI 1.1 to 1.3; P ‫؍‬ 0.005), and 3-mo creatinine (OR 2.0; 95% CI 1.2 to 3.3; P ‫؍‬ 0.044) were associated with 12-mo PTA. The PTA cohort had inferior patient survival (P ‫؍‬ 0.02, log rank) and a higher proportion of cardiovascular deaths (6.3 versus 2.2%; P ‫؍‬ 0.017) than nonanemic patients. By Cox regression, 12-mo PTA (hazard ratio [HR] 3.0; 95% CI 1.3 to 6.7; P ‫؍‬ 0.009), 12-mo creatinine (HR 1.3; 95% CI 1.1 to 1.4; P ‫؍‬ 0.008), age at transplantation (HR 1.1; 95% CI 1.1 to 1.2; P ‫؍‬ 0.004), and hepatitis C seropositivity (HR 2.8; 95% CI 1.1 to 7.0; P ‫؍‬ 0.03) were associated with mortality. There was no interaction between 12-mo PTA and serum creatinine. In conclusion, 12-mo PTA is associated with an increased risk for patient death. The presence of anemia 3 mo after kidney transplantation is a major determinant of 12-mo PTA. PTA in kidney recipients therefore should be defined by its persistence or occurrence beyond the third posttransplantation month.

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… Life Lies Waiting

Cited by 15 publications

References 6 publications

The Burden of Chronic Kidney Disease in Renal Transplant Recipients

The Burden of Chronic Kidney Disease in Renal Transplant Recipients

Anaemia after Renal Transplantation – Role of Immunosuppressive Drugs and a Pathophysiological Appraisal

Posttransplantation Anemia at 12 Months in Kidney Recipients Treated with Mycophenolate Mofetil

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