Unexpectedly high prevalence of posttransplant anemia in pediatric and young adult renal transplant recipients

Peter D. Yorgin, Amir Belson, Jaime Sanchez, Amira Al-Uzri, Minnie Sarwal, Daniel A. Bloch, John Oehlert, Oscar Salvatierra, Steven R. Alexander

Research output: Contribution to journalArticle

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Abstract

Background: Although posttransplant anemia (PTA) is recognized as a common problem in adult renal transplant recipients, few pediatric studies have been published. Methods: In this retrospective cohort study of 162 pediatric renal transplant recipients treated at Stanford University, the authors sought to determine the prevalence, severity, and the predictive factors of PTA. Anemia was defined as a hematocrit (HCT) level greater than 2 SD below published means for age or as erythropoietin dependency to maintain a normal HCT. Results: Sixty-seven percent of pediatric renal transplant recipients were anemic at the time of transplantation. The prevalence of anemia increased to 84.3% in the first month posttransplant. From 6 months to 60 months posttransplant, the prevalence of anemia remained high at 64.2% to 82.2%. Only 4 patients (2.5%) were never anemic. Iron depletion was detected in 19 of 26 and 23 of 23 anemic patients 12 and 60 months posttransplant, respectively. Serum erythropoietin levels were low relative to hematocrit levels in 38 of 56 anemic patients. Logistic regression at 3 months posttransplant showed that discharge hematocrit level (P <0.0001), calcium (P = 0.0004), and cyclosporine dose (P = 0.0002) correlated with anemia. Creatinine clearance (P = 0.002) and white blood cell count (P = 0.004) correlated with anemia at 12 months posttransplant, but only creatinine clearance (P = 0.011) correlated with anemia 60 months posttransplant. Conclusion: Nearly all pediatric renal transplant recipients experience PTA. However, few children less than 2 years of age were anemic during the first year posttransplant. Antirejection therapy, bone disease, iron depletion, and creatinine clearance appear to play pivotal roles in the development of PTA in children.

Original languageEnglish (US)
Pages (from-to)1306-1318
Number of pages13
JournalAmerican Journal of Kidney Diseases
Volume40
Issue number6
DOIs
StatePublished - Dec 1 2002

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Anemia
Young Adult
Pediatrics
Kidney
Hematocrit
Creatinine
Erythropoietin
Iron
Transplant Recipients
Bone Diseases
Leukocyte Count
Immunosuppression
Cyclosporine
Cohort Studies
Retrospective Studies
Transplantation
Logistic Models
Calcium
Serum

Keywords

  • Calculated creatinine clearance
  • Children
  • Complication
  • Erythropoietin (EPO)
  • Hematocrit (HCT)
  • Immunosuppression
  • Iron deficiency

ASJC Scopus subject areas

  • Nephrology

Cite this

Unexpectedly high prevalence of posttransplant anemia in pediatric and young adult renal transplant recipients. / Yorgin, Peter D.; Belson, Amir; Sanchez, Jaime; Al-Uzri, Amira; Sarwal, Minnie; Bloch, Daniel A.; Oehlert, John; Salvatierra, Oscar; Alexander, Steven R.

In: American Journal of Kidney Diseases, Vol. 40, No. 6, 01.12.2002, p. 1306-1318.

Research output: Contribution to journalArticle

Yorgin, PD, Belson, A, Sanchez, J, Al-Uzri, A, Sarwal, M, Bloch, DA, Oehlert, J, Salvatierra, O & Alexander, SR 2002, 'Unexpectedly high prevalence of posttransplant anemia in pediatric and young adult renal transplant recipients', American Journal of Kidney Diseases, vol. 40, no. 6, pp. 1306-1318. https://doi.org/10.1053/ajkd.2002.36910
Yorgin, Peter D. ; Belson, Amir ; Sanchez, Jaime ; Al-Uzri, Amira ; Sarwal, Minnie ; Bloch, Daniel A. ; Oehlert, John ; Salvatierra, Oscar ; Alexander, Steven R. / Unexpectedly high prevalence of posttransplant anemia in pediatric and young adult renal transplant recipients. In: American Journal of Kidney Diseases. 2002 ; Vol. 40, No. 6. pp. 1306-1318.
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abstract = "Background: Although posttransplant anemia (PTA) is recognized as a common problem in adult renal transplant recipients, few pediatric studies have been published. Methods: In this retrospective cohort study of 162 pediatric renal transplant recipients treated at Stanford University, the authors sought to determine the prevalence, severity, and the predictive factors of PTA. Anemia was defined as a hematocrit (HCT) level greater than 2 SD below published means for age or as erythropoietin dependency to maintain a normal HCT. Results: Sixty-seven percent of pediatric renal transplant recipients were anemic at the time of transplantation. The prevalence of anemia increased to 84.3{\%} in the first month posttransplant. From 6 months to 60 months posttransplant, the prevalence of anemia remained high at 64.2{\%} to 82.2{\%}. Only 4 patients (2.5{\%}) were never anemic. Iron depletion was detected in 19 of 26 and 23 of 23 anemic patients 12 and 60 months posttransplant, respectively. Serum erythropoietin levels were low relative to hematocrit levels in 38 of 56 anemic patients. Logistic regression at 3 months posttransplant showed that discharge hematocrit level (P <0.0001), calcium (P = 0.0004), and cyclosporine dose (P = 0.0002) correlated with anemia. Creatinine clearance (P = 0.002) and white blood cell count (P = 0.004) correlated with anemia at 12 months posttransplant, but only creatinine clearance (P = 0.011) correlated with anemia 60 months posttransplant. Conclusion: Nearly all pediatric renal transplant recipients experience PTA. However, few children less than 2 years of age were anemic during the first year posttransplant. Antirejection therapy, bone disease, iron depletion, and creatinine clearance appear to play pivotal roles in the development of PTA in children.",
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T1 - Unexpectedly high prevalence of posttransplant anemia in pediatric and young adult renal transplant recipients

AU - Yorgin, Peter D.

AU - Belson, Amir

AU - Sanchez, Jaime

AU - Al-Uzri, Amira

AU - Sarwal, Minnie

AU - Bloch, Daniel A.

AU - Oehlert, John

AU - Salvatierra, Oscar

AU - Alexander, Steven R.

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N2 - Background: Although posttransplant anemia (PTA) is recognized as a common problem in adult renal transplant recipients, few pediatric studies have been published. Methods: In this retrospective cohort study of 162 pediatric renal transplant recipients treated at Stanford University, the authors sought to determine the prevalence, severity, and the predictive factors of PTA. Anemia was defined as a hematocrit (HCT) level greater than 2 SD below published means for age or as erythropoietin dependency to maintain a normal HCT. Results: Sixty-seven percent of pediatric renal transplant recipients were anemic at the time of transplantation. The prevalence of anemia increased to 84.3% in the first month posttransplant. From 6 months to 60 months posttransplant, the prevalence of anemia remained high at 64.2% to 82.2%. Only 4 patients (2.5%) were never anemic. Iron depletion was detected in 19 of 26 and 23 of 23 anemic patients 12 and 60 months posttransplant, respectively. Serum erythropoietin levels were low relative to hematocrit levels in 38 of 56 anemic patients. Logistic regression at 3 months posttransplant showed that discharge hematocrit level (P <0.0001), calcium (P = 0.0004), and cyclosporine dose (P = 0.0002) correlated with anemia. Creatinine clearance (P = 0.002) and white blood cell count (P = 0.004) correlated with anemia at 12 months posttransplant, but only creatinine clearance (P = 0.011) correlated with anemia 60 months posttransplant. Conclusion: Nearly all pediatric renal transplant recipients experience PTA. However, few children less than 2 years of age were anemic during the first year posttransplant. Antirejection therapy, bone disease, iron depletion, and creatinine clearance appear to play pivotal roles in the development of PTA in children.

AB - Background: Although posttransplant anemia (PTA) is recognized as a common problem in adult renal transplant recipients, few pediatric studies have been published. Methods: In this retrospective cohort study of 162 pediatric renal transplant recipients treated at Stanford University, the authors sought to determine the prevalence, severity, and the predictive factors of PTA. Anemia was defined as a hematocrit (HCT) level greater than 2 SD below published means for age or as erythropoietin dependency to maintain a normal HCT. Results: Sixty-seven percent of pediatric renal transplant recipients were anemic at the time of transplantation. The prevalence of anemia increased to 84.3% in the first month posttransplant. From 6 months to 60 months posttransplant, the prevalence of anemia remained high at 64.2% to 82.2%. Only 4 patients (2.5%) were never anemic. Iron depletion was detected in 19 of 26 and 23 of 23 anemic patients 12 and 60 months posttransplant, respectively. Serum erythropoietin levels were low relative to hematocrit levels in 38 of 56 anemic patients. Logistic regression at 3 months posttransplant showed that discharge hematocrit level (P <0.0001), calcium (P = 0.0004), and cyclosporine dose (P = 0.0002) correlated with anemia. Creatinine clearance (P = 0.002) and white blood cell count (P = 0.004) correlated with anemia at 12 months posttransplant, but only creatinine clearance (P = 0.011) correlated with anemia 60 months posttransplant. Conclusion: Nearly all pediatric renal transplant recipients experience PTA. However, few children less than 2 years of age were anemic during the first year posttransplant. Antirejection therapy, bone disease, iron depletion, and creatinine clearance appear to play pivotal roles in the development of PTA in children.

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