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Full Correction of Posttransplant Anemia Is Associated With Stabilized Cardiac Dimensions Among Kidney Transplant
Torki Al-Otaibi1, Ayman M Nagib, Medhat A Halim
1From Hamed Al-Essa Organ Transplant Center, Kuwait, Kuwait.
Insights
Full correction of posttransplant anemia in kidney transplant recipients improved quality of life and cardiac function. This approach using erythropoietin-stimulating agents did not impact cardiovascular comorbidity.
Area of Science:
- Nephrology
- Cardiology
- Transplantation Medicine
Background:
- Posttransplant anemia is linked to cardiovascular issues and mortality.
- Anemia correction strategies require updated evaluation.
- Erythropoietin-stimulating agents are commonly used in posttransplant care.
Purpose of the Study:
- To evaluate the impact of full anemia correction on cardiovascular health.
- To assess improvements in quality of life for renal transplant recipients.
- To investigate effects in patients with stable graft function using erythropoietin-stimulating agents.
Main Methods:
- 247 kidney recipients with stable graft function were randomized.
- Group 1: target hemoglobin 11-12 g/dL; Group 2: target hemoglobin 13-15 g/dL.
- Evaluations included clinical/laboratory assessments, quality of life surveys, and echocardiography at baseline and 12 months.
Main Results:
- Group 2 showed better graft function at 6 months and improved cardiac indexes at 1 year.
- Quality of life significantly improved in the full correction group (Group 2) at 12 months.
- No significant difference in posttransplant complications between groups.
Conclusions:
- Full correction of posttransplant anemia enhances quality of life and cardiac function.
- Erythropoietin-stimulating agent therapy for anemia correction is effective.
- No adverse effect on cardiovascular comorbidity was observed with full anemia correction.
Objectives:
Posttransplant anemia might be associated with cardiovascular morbidity and increased mortality. To our knowledge, the debate on anemia correction has neither been revisited nor decided definitively. We aimed to assess the effects of full correction of posttransplant anemia on the cardiovascular system and quality of life among renal transplant recipients with stable graft function who were using erythropoietin-stimulating agents.
Materials And Methods:
We enrolled 247 kidney recipients with stable graft function to be assessed for anemia. Eligible patients were randomized to achieve targeted hemoglobin of 11 to 12 g/dL (group 1, n = 183) or of 13 to 15 g/dL (group 2, n = 64) with the use of erythropoietin-stimulating agents. Patients underwent monthly clinical and laboratory evaluations of kidney graft function. Quality of life and echocardiography were assessed at study start and at 12 months.
Results:
The 2 groups were comparable regarding pretransplant characteristics. In group 2, we observed comparable posttransplant complications (P > .05) but better graft function at 6 months and better cardiac indexes at 1 year of the study (P < .05). At 12 months, quality of life had improved after full correction of posttransplant anemia in the renal transplant recipients who received erythropoietinstimulating agents.
Conclusions:
Full correction of posttransplant anemia in renal transplant recipients was associated with improved quality of life and cardiac indexes without an effect on cardiovascular comorbidity.
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