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.