39th National Congress of the Italian Society of Organ Transplantation
Renal transplantation
Anemia and Immunosuppressive Regimen in Renal Transplanted Patients: Single-Center Retrospective Study

https://doi.org/10.1016/j.transproceed.2015.12.054Get rights and content

Highlights

  • Anemia is a frequent complication after renal transplantation.

  • Every class of immunosuppressive drugs is associated with some risk of developing anemia.

  • In our analysis, everolimus-based therapy is not associated with a higher incidence of anemia compared to a mycophenolate-based therapy.

Abstract

We compared retrospectively the level of hemoglobin and the percentage of patients with anemia among 59 kidney transplant recipients receiving everolimus, cyclosporine, and corticosteroids and 128 treated with cyclosporine, mycophenolic acid, and corticosteroids. We also compared age at the time of transplantation, sex and ferritine, serum creatinine, creatinine clearance, folic acid, cyanocobalamine levels, use od recombinant erythropoietin, mean corpuscolar volume at the last ambulatory control. Statistical analysis included Student t test, χ2 test, and logistic regression. The analysis was performed using SPSS software. We observed no difference in terms of hemoglobin levels in patients treated with everolimus (12.9 ± 1.6 vs 12.7 ± 1.5 g/dL). Anemia (defined as hemoglobin <13 g/dL in men and <12 g/dL in women, or need to use erythropoietin) was found in 49% and 45% of patients in the 2 groups respectively (P = .6). The other parameters evaluated were similar except for the mean corpuscular volume, which was significantly lower in the everolimus group. In the multivariate analysis only serum creatinine and estimated glomerular filtration rate influenced the level of hemoglobin. We observed no differences in terms of development of anemia in renal transplanted patients treated with everolimus-based regimen.

Section snippets

Materials and Methods

In this retrospective study, we selected from our cohort of transplanted patients currently on follow up in our clinic 59 treated with Rad, Cya, and corticosteroids (CS), and 128 treated with Cya, MPA, and CS. All the transplantations were performed in our unit between 2006 and 2013 and compared Hb and percentage of patients affected by anemia in the 2 groups. Anemia was defined as Hb < 13 g/dL in men and <12 g/dL in women or need to use recombinant erythropoietin (rEPO). We also compared

Results

The 2 groups were comparable for baseline characteristics. We observed no difference in terms of Hb levels in patients treated with Rad (12.9 ± 1.6 vs 12.7 ± 1.5 g/dL). PTA was found in 49% and 45% of patients in the 2 groups, respectively (P = .6). The 2 groups had similar levels of serum creatinine, eGFR, ferritin, folic acid, and cyanocobalamin. Only the MCV was significantly lower in the Rad group, as expected. In the multivariate analysis only serum creatinine and eGFR have an influence on

Discussion

In this study we evaluated whether Rad-based therapy is associated with a higher risk of developing PTA with respect to MPA. Available data from literature regarding the issue of PTA and use of mTOR are mainly related to the use of SRL. In a review by Fishbane et al [5], the authors conclude that although SRL may be a contributing factor for PTA, it is impossible to dissect with any certainty its independent causative role from the combined effects of SRL administered along with other

Conclusions

In our study population, treatment with Rad was not associated with a higher percentage of patients with PTA.

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