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Pediatric Nephrology
Published in: Pediatric Nephrology 2/2016

01-02-2016 | Original Article

Anemia in children following renal transplantation—results from the ESPN/ERA-EDTA Registry

Authors: Leah A. Krischock, Karlijn J. van Stralen, Enrico Verrina, E. Jane Tizard, Marjolein Bonthuis, György Reusz, Farida K Hussain, Augustina Jankauskiene, Gregor Novljan, Brankica Spasojević-Dimitrijeva, Ludmila Podracka, Vera Zaller, Kitty J. Jager, Franz Schaefer, on behalf of the ESPN/ERA-EDTA Registry

Published in: Pediatric Nephrology | Issue 2/2016

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Abstract

Background

Our aim was to determine the prevalence of sub-target hemoglobin (Hb) levels in children with a renal allograft and to identify potential determinants associated with these Hb levels.

Methods

Data from 3669 children with a functioning renal allograft, aged <18 years between 1 January 2000 and 31 December 2012, from 20 European countries were retrieved from the ESPN/ERA-EDTA Registry, providing 16,170 Hb measurements.

Results

According to the NKF/KDOQI classification and the UK-NICE guidelines, 49.8 and 7.8 % of the patients, respectively, were anemic. Hb levels were strongly associated with graft function, with Hb levels of 12.6 g/dl in children with chronic kidney disease (CKD) stage 1, declining to 10.7 g/dl in children with CKD stage 5 (P < 0.001). Higher Hb levels were associated with the use of tacrolimus compared to ciclosporin (0.14 g/dl; 95 % confidence interval 0.02–0.27; P = 0.002). Low Hb levels were associated with an increased risk of graft failure (P = 0.01) or combined graft failure and death (P < 0.01), but not with death alone (not significant).

Conclusions

Anemia is present in a significant proportion of European pediatric kidney transplant recipients and is associated with renal allograft dysfunction and type of immunosuppressants used. In our patient cohort, higher Hb levels were associated with better graft and patient survival and less hypertension.
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Metadata
Title
Anemia in children following renal transplantation—results from the ESPN/ERA-EDTA Registry
Authors
Leah A. Krischock
Karlijn J. van Stralen
Enrico Verrina
E. Jane Tizard
Marjolein Bonthuis
György Reusz
Farida K Hussain
Augustina Jankauskiene
Gregor Novljan
Brankica Spasojević-Dimitrijeva
Ludmila Podracka
Vera Zaller
Kitty J. Jager
Franz Schaefer
on behalf of the ESPN/ERA-EDTA Registry
Publication date
01-02-2016
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Nephrology / Issue 2/2016
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI
https://doi.org/10.1007/s00467-015-3201-8

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