Anemia is a predictor of graft loss but not cardiovascular events and all-cause mortality in renal transplant recipients: follow-up data from the ALERT study

Schjelderup, P., Dahle, D.O., Holdaas, H., Mjøen, G., Nordby, G., Abedini, S., Jardine, A. , Fellström, B. and Svensson, M. (2013) Anemia is a predictor of graft loss but not cardiovascular events and all-cause mortality in renal transplant recipients: follow-up data from the ALERT study. Clinical Transplantation, 27(6), E636-E643. (doi: 10.1111/ctr.12220)

Abstract

Background It is well established that post-transplantation anemia (PTA) in renal transplant recipients (RTRs) is associated with reduced graft survival. However, there is an uncertainty of the effect of PTA on cardiovascular events and all-cause mortality. We examined prospectively in a large cohort of erythropoietin-naive patients the effects of PTA on cardiovascular morbidity, patient survival, and graft survival.<p></p> Methods A prospective cohort study of RTRs (n = 2102) included in the ALERT study. Cox regression models were used to evaluate the impact of PTA on study endpoints: first occurrence of a major adverse cardiac event, all-cause death, and the incidence of death-censored graft loss. Mean follow-up was 6.7 yr. All endpoints were adjudicated by an independent endpoint committee.<p></p> Results Twenty-nine percent of women and 30% of men were anemic. Hemoglobin levels were not associated with any effect on cardiovascular morbidity and mortality (HR 0.97 [0.90–1.05] per g/dL, p = 0.48) or all-cause death (HR 0.96 [0.90–1.03] per g/dL, p = 0.24) after extensive multivariate adjustments for clinical and demographic factors. Hemoglobin levels were negatively associated with graft loss (HR 0.86 [0.80–0.92] per g/dL, p < 0.001).<p></p> Conclusions PTA was not associated with an increased incidence of cardiovascular morbidity and mortality or all-cause mortality.<p></p>

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Jardine, Professor Alan
• Authors: Schjelderup, P., Dahle, D.O., Holdaas, H., Mjøen, G., Nordby, G., Abedini, S., Jardine, A., Fellström, B., and Svensson, M.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
• Journal Name: Clinical Transplantation
• ISSN: 0902-0063
• ISSN (Online): 1399-0012