TORONTO, April 18 -- Anemia after kidney transplantation nearly doubles mortality and graft failure risk over four years, according to international researchers.
Among 938 Hungarian kidney transplant patients, anemia raised the mortality risk 69% and graft failure risk 2.5-fold, reported Istvan Mucsi, M.D., of the University of Toronto and Semmelweis University in Budapest, and colleagues, in the April issue of the American Journal of Transplantation.
The results suggested that post-renal transplant anemia should be treated according to National Kidney Foundation's Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines for chronic kidney disease-related anemia, Dr. Mucsi said.
However, the treatment of anemia as a complication of chronic kidney disease is itself undergoing changes that suggest caution in use of erythropoiesis-stimulating agents, said Matthew R. Weir, M.D., of the University of Maryland in Baltimore, in an accompanying editorial.
Last month, the FDA issued a black box warning for erythropoiesis-stimulating agents, including darbepoetin alfa (Aranesp) and epoetin alfa (Epogen, Procrit), that pointed out aggressively raising hemoglobin to a target of 12 g/dL or higher was associated with "serious and life-threatening side-effects and/or death."
Two of the studies that sparked the warning -- CREATE and CHOIR -- were testing higher hemoglobin targets for chronic kidney disease patients not on dialysis.
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