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Prevalence and management of post-transplant anemia in long-term follow-up of Chinese kidney transplant recipients: a single-center report

Zhixian Wu, Junqi Guo, Lianming Liao, Weizhen Wu, Shunliang Yang and Jianming Tan*

Author Affiliations

Organ Transplant Institute, Fuzhou General Hospital, Xiamen University, 156 West Er’huan Road, Fuzhou 350025, China

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European Journal of Medical Research 2013, 18:45  doi:10.1186/2047-783X-18-45

Published: 15 November 2013



Post-transplant anemia (PTA) has long been a less-recognized complication in kidney transplant recipients, and its prevalence also tends to be underestimated. This study sought to evaluate the prevalence, management, and risk factors of PTA from a group of long-term follow-up Chinese kidney transplant recipients.


One hundred and fifty-four adult kidney transplant recipients were followed up at Fuzhou General Hospital, China, and retrospectively studied.


PTA prevalence at transplant and at 5-yearly time points after transplantation were 45.5%, 10.7%, 9.6%, 14.8%, 13.5%, and 19.6%, respectively. Overall, 38.3% of patients had been anemic at least once during the follow-up period, and 42% of these patients had recurrent anemia. Correlation analysis indicated that hemoglobin levels were associated with graft function. No correlations between anemia and age, gender, immunosuppressive regimens, or antihypertensive agents were observed. Binary logistic regression analysis suggested that serum creatinine and blood urea nitrogen were associated with the diagnosis of anemia at 1 year post-transplant. At 5 years post-transplant, only serum creatinine concentrations correlated with anemia. Although iron drugs are frequently used, erythropoietin was rarely administered in those anemic patients suffering poor graft function that necessitated such therapies.


The prevalence of PTA is noticeably high, and impaired kidney graft function seemed to be the major risk factor for anemia. There is an urgent need to improve current PTA management and to establish modified guidelines for this common complication in kidney transplant recipients.

Anemia; Calculated creatinine clearance; Erythropoietin; Immunosuppressive; Iron deficiency