[Anemia after renal transplantation]. / L'anemia nel trapiantato di rene.

ABSTRACT

The anemia which commonly accompanies end-stage kidney disease usually remits within 10 - 16 weeks following successful kidney transplantation. However, a significant number of patients remain anemic or become anemic after transplantation. Unlike the great amount of data available on anemia in end-stage renal disease population, much less is known about post-transplant anemia (PTA). Existing literature data indicate that PTA prevalence is high; the findings of a few longitudinal studies showed a very high prevalence of PTA in the early post-transplantation period; during the first 5-year post-transplant period, 30-40% of transplant patients are anemic, and PTA increases subsequently after transplantation. Available information suggests that PTA prevalence is higher in pediatric compared to adult patients. A decrease in renal allograft function has been identified in several studies as the most important risk factor for PTA development. Other common causes of PTA include iron deficiency, systemic illnesses, acute and chronic infections, and drug toxicities. Several reports indicate that PTA is associated with an increased cardiovascular disease risk. Although PTA is a frequent problem in transplanted patients, iron and erythropoietin therapy are even underused in this population. Erythropoietinis effective and safe in correcting anemia during both early and late post-transplantation period. Prospective interventional studies in anemic kidney transplant recipients are needed to determine the most appropriate hemoglobin target in these patients and the potential beneficial role of erythropoietin therapy for cardiovascular and renal protection.