Anemia After Kidney Transplantation; Its Prevalence, Risk Factors, and Independent Association With Graft and Patient Survival: A Time-Varying Analysis

[摘要]：Introduction. Posttransplant anemia and its association with transplant outcomes have not been properly studied. Methods. We examined 530 renal allograft recipients transplanted at our center and followed up for 31.0 +/- 14.1 months. Hemoglobin (Hb), serum bicarbonate, and creatinine; use of erythropoiesis-stimulating agent (ESA) and iron; and immunosuppressive regimen data were obtained at multiple time points during 24-month posttransplant. Results. The overall prevalence of anemia was 89.4% at the time of transplant, dropping to 49.2% at 1 year and 44.3% at 2 years. ESA use decreased from 25.6% at 1 month to 8.23% at 24 months, only in 30.9% to 51.2% with severe anemia; 21.0% to 29.2% received iron supplements. Factors independently predictive of Hb included male gender (beta = 0.64, P<0.001, confidence interval [CI]: 0.45-0.82), estimated glomerular filtration rate (beta = 0.21 per 10 mL/min/1.73 m(2), P<0.001; CI: 0.16-0.27), bicarbonate (beta = 0.4 per 10 mmol/L increase, P<0.001; CI: 0.31-0.85), using angiotensin-converting enzyme inhibitor/angiotensin receptor blocker (beta = 0.36, P<0.001; CI: 0.16-0.55), African American race (beta = -0.34, P=0.001, CI: -0.54 to -0.14), iron (beta = -0.28, P=0.003, CI: -0.47 to -0.09) and ESA use (beta = -0.73, P

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