Abstract: PUB334
Post-Transplant Anemia Remains a Risk Factor for Graft Dysfunction in Kidney Transplant Recipients
Session Information
Category: Transplantation
- 2102 Transplantation: Clinical
Author
- Tsujita, Makoto, Tajimi Clinic, Tajimi, Japan
Background
Our previous report on post-transplant anemia (PTA) in kidney transplantation demonstrated that maintaining higher hemoglobin (Hb) levels with erythropoiesis-stimulating agents (ESA) plays a crucial role in preserving graft function in kidney transplant recipients.(NDT, 2019) However, it remains unclear whether these Hb levels are sufficient to ensure long-term graft stability.
Methods
This retrospective study was conducted at Masuko Memorial Hospital in Japan from 2019 to 2021 to evaluate the potential for maintaining graft function in patients with ESA versus those without ESA in real clinical practice. Graft function was compared between the two groups over a two-year period.
Results
A total of 323 outpatients were enrolled in this study . Of them, 108 patients (33.4%) were in patients with ESA. 69.3 % were male in patients without ESA, and 58.3 % in patients with ESA. The mean age (years old) was 51.2 ± 13.2 and 51.3 ± 13.4. The mean hemoglibin (Hb) (g/dL) was 13.4 and 12.0. The mean <!--StartFragment -->estimated glomerular filtration rate<!--EndFragment --> (eGFRave) (mL/min/1.73 m2) was 51.1 ± 14.0 and 39.3 ± 13.6. The median urine protein (g/gCre) was 0.11 [0.07, 0.22] and 0.18 [0.08, 0.38], respectively. There was no significant difference in blood pressure and BMI between the two groups. After 2 years, changes in eGFRave were − 3.12 mL/min/1.73 m2 (95% CI; − 3.89 to −2.36) and − 4.73 mL/min/1.73 m2 (95% CI;− 5.89 to −3.57) (p = 0.021). In multivariate analysis, Hb levles, eGFR and urinary protein at baseline, not ESA use, were statistically significant factors. After propensity matching, patient backgrounds were balanced between the two groups except for Hb levels. Changes in eGFRave over two years were − 3.0 mL/min/1.73 m2 (95% CI; − 4.1 to −1.93) and − 5.66 mL/min/1.73 m2 (95% CI; − 7.1 to −4.3) (p = 0.003).
Conclusion
Despite the correction of anemia with ESA, PTA remained a risk factor for graft function. Further studies are needed to determine whether significantly higher Hb levels could enhance graft function in kidney transplant recipients.