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

作者：Schjelderup Patrick^*; Dahle Dag Olav; Holdaas Hallvard; Mjoen Geir; Nordby Gudrun; Abedini Sadollah; Jardine Alan; Fellstrom Bengt; Svensson My

来源：Clinical Transplantation, 2013, 27(6): E636-E643.

DOI：10.1111/ctr.12220

• anemia
• chronic kidney disease
• graft survival
• kidney transplantation
• mortality

BackgroundIt 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. %26lt;br%26gt;MethodsA 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 6.7yr. All endpoints were adjudicated by an independent endpoint committee. %26lt;br%26gt;ResultsTwenty-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%26lt;0.001). %26lt;br%26gt;ConclusionsPTA was not associated with an increased incidence of cardiovascular morbidity and mortality or all-cause mortality.

• 出版日期2013-11