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25-10-2022 | Erythropoietin | Educational Review

Anemia after kidney transplantation

Authors: Isabella Guzzo, Meredith A. Atkinson

Published in: Pediatric Nephrology | Issue 10/2023

Abstract

Anemia is a frequent complication in pediatric kidney transplant recipients (KTR) with a variable reported prevalence estimated between 20 and 80% depending on how defined. Causes of and risk factors for post-transplantation anemia (PTA) are multifactorial with iron deficiency being the primary cause of early PTA (within the first 6 months after transplantation) and impaired glomerular filtration rate (GFR) commonly responsible for late PTA (after 6 months). Medications, viral infections, chronic inflammation, and comorbidities also play a role. PTA has relevant long-term consequences and is a potential risk factor for allograft dysfunction, cardiovascular morbidity, and mortality. Thus, an anemia evaluation, approximately 3 months post-transplantation, is recommended in order to start early treatment and improve prognosis. Iron status, vitamin B₁₂, folate, markers of hemolysis, and viral PCR should be checked, and medications, in particular combinations of medications, should be carefully evaluated. PTA treatment may be challenging and should be directed to the underlying causes. Iron supplementation and erythropoietin therapy, not extensively used in KTR, may be indicated. Every effort should be made to avoid blood transfusions in the pre-transplant period to avoid allosensitization. Anemia should be corrected to prepare candidates for kidney transplantation in order to reduce the need for perioperative blood transfusions as well.

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Title: Anemia after kidney transplantation
Authors: Isabella Guzzo
Meredith A. Atkinson
Publication date: 25-10-2022
Publisher: Springer Berlin Heidelberg
Keywords: Erythropoietin
Kidney Transplantation
Anemia
Erythropoietin
Kidney Transplantation
Kidney Transplantation
Iron Deficiency
Kidney Transplantation
Kidney Transplantation
Kidney Transplantation
Epoetin alfa
Published in: Pediatric Nephrology / Issue 10/2023
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-022-05743-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Anemia after kidney transplantation

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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