Late anemia in pediatric kidney transplant recipients: Prevalence and risk factors

Background: Anemia is a frequent complication among pediatric transplant recipients. However, limited published studies are currently available about anemia in these patients. Objectives: We conducted a retrospective study to determine the prevalence and risk factors of late post-transplant anemia (PTA) among pediatric kidney transplant patients. Patients and Methods: A total of 78 kidney transplant patients ≤ 18 years old were enrolled. Prevalence of late PTA, beyond 1 year after transplantation, in children was evaluated between 2008 and 2011. We considered anemia as hemoglobin concentration of ≤ 11 mg/dl and less than 10 mg/dl as a severe anemia. Both univariate and multivariate analyses were performed to determine the correlation of PTA with other risk factors such as renal allograft function and other laboratory parameters. Results: The mean age of recipients was 10 ± 3 years (range: 3 to 18 years); 58% male and 42% female. The prevalence PTA in this survey was 15.4% (n = 12). The prevalence of late PTA was not different in both boys and girls (p = 0.38). At univariate analysis, a significant relationship was seen between serum creatinine concentrations and Hb levels (P = 0.005, r = 0.32) and there was also a significant relationship between serum Hb and cyclosporine trough blood level (p = 0.009, r = 0.29) and 2 hour post dose level of cyclosporine (p = 0.03, r = 0.29). At multivariate logistic regression after adjustment for other factors, however, renal allograft impairment was the only a risk factor for late PTA (P = 0.05, EXP (B) = 2.5; 95 % CI = 1.0- 6.3). Conclusions: The prevalence of late PTA in our children was lower than previously reported in literature from both adult and pediatric transplant patients.