Anemia Is Associated with Mortality in Kidney-Transplanted Patients—A Prospective Cohort Study

doi:10.1111/j.1600-6143.2006.01727.x

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Wiley InterScience

American Journal of Transplantation

Volume 7 Issue 4, Pages 818 - 824

Published Online: 26 Mar 2007

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Anemia Is Associated with Mortality in Kidney-Transplanted Patients—A Prospective Cohort Study

M. Z. Molnar ^a,b,c , M. Czira ^a , C. Ambrus ^b,c , L. Szeifert ^a , A. Szentkiralyi ^a , G. Beko ^d , L. Rosivall ^e , A. Remport ^f , M. Novak ^a,g and I. Mucsi ^a,b,e,*

^a Institute of Behavioral Sciences, Semmelweis University, Budapest, Hungary, ^b 1st Department of Internal Medicine, Semmelweis University, Budapest, Hungary , ^c Semmelweis University—Fresenius Medical Care Dialysis Center, Budapest, Hungary , ^d Central Laboratory, Semmelweis University, Budapest, Hungary , ^e Hungarian Academy of Sciences and Semmelweis University Nephrology Research Group, Budapest, Hungary and ^f Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary ^g Department of Psychiatry, University Health Network, University of Toronto, Toronto, Canada

*Corresponding author: Istvan, Mucsi istvan@nefros.net

KEYWORDS

Anemia • chronic renal disease • kidney • mortality • transplantation outcomes

ABSTRACT

Although anemia is a known risk factor of mortality in several patient populations, no prospective study to date has demonstrated association between anemia and mortality in kidney-transplanted patients. In our prospective cohort study (TransQol-HU Study), we tested the hypothesis that anemia is associated with mortality and graft failure (return to dialysis) in transplanted patients. Data from 938 transplanted patients, followed at a single outpatient transplant center, were analyzed. Sociodemographic parameters, laboratory data, medical history and information on comorbi-dity were collected at baseline. Data on 4-year outcome (graft failure, mortality or combination of both) were collected prospectively from the patients' charts. Both mortality and graft failure rate during the 4-year follow-up was significantly higher in patients who were anemic at baseline (for anemic vs nonanemic patients, respectively: mortality 18% vs. 10%; p < 0.001; graft failure 17% vs 6%; p < 0.001). In multivariate Cox proportional hazard models the presence of anemia significantly predicted mortality (HR = 1.690; 95% CI: 1.115–2.560) and also graft failure (HR = 2.465; 95% CI: 1.485–4.090) after adjustment for several covariables. Anemia, which is a treatable complication, is signi-ficantly and independently associated with mortality and graft failure in kidney-transplanted patients.

Received 2 October 2006, revised 4 December 2006 and accepted for publication 21 December 2006

DIGITAL OBJECT IDENTIFIER (DOI)

10.1111/j.1600-6143.2006.01727.x About DOI