Impact of pre-transplant anaemia correction and erythropoietin resistance on long-term graft survival
| Autor: | Allan J. Collins, Ashraf Mikhail, Mariarosaria Campise, Jon J. Snyder, Thomas Quaschning |
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| Rok vydání: | 2005 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Drug Resistance Gastroenterology Internal medicine medicine Humans Cumulative incidence Erythropoietin Dialysis Aged Transplantation business.industry Incidence (epidemiology) Graft Survival Patient survival Anemia Middle Aged medicine.disease Kidney Transplantation Recombinant Proteins Surgery surgical procedures operative Nephrology Female Hemodialysis business Kidney disease medicine.drug |
| Zdroj: | Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association. 20 |
| ISSN: | 0931-0509 |
| Popis: | Background. This study investigated whether recombinant human erythropoietin (rHuEPO)-hyporesponsive anaemia before transplantation is associated with a poorer graft outcome and lower patient survival. Methods. A total of 15 051 kidney transplant recipients, with a minimum follow-up of 1 year, were stratified as either rHuEPO hyporesponsive or rHuEPO responsive (using a threshold rHuEPO-treated haemoglobin level of 11 g/dl). They were followed for a median of 24 months. Outcomes included times from transplantation to graft failure (including patient death), return to dialysis or pre-emptive re-transplantation, and death with a functioning graft. Results. The cumulative incidence of graft failure was 50% for rHuEPO-hyporesponsive patients, compared with 41.7% for rHuEPO responders (P ¼ 0.0091). Among rHuEPO-hyporesponsive patients, 41.7% returned to dialysis or underwent a pre-emptive re-transplantation, compared with 32% of rHuEPO responders (P ¼ 0.0091). Death with a functioning graft occurred in 16.9% of rHuEPO-hyporesponsive and in 15% of rHuEPO-responsive patients (P ¼ 0.3949). Conclusions. The results showed higher mortality and higher incidence of graft failure at 5 years for rHuEPO-hyporesponsive patients. It is unclear whether anaemia treatment per se or treatment of more severe co-morbidity resulting in hyporesponsiveness to anaemia treatment may be causally linked to reduced renal transplant outcomes. |
| Databáze: | OpenAIRE |
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