TY - JOUR
T1 - Iron deficiency anemia and iron losses after renal transplantation
AU - Zheng, Sijie
AU - Coyne, Daniel W.
AU - Joist, Heidi
AU - Schuessler, Rebecca
AU - Godboldo-Brooks, Ambyr
AU - Ercole, Patrick
AU - Brennan, Daniel C.
PY - 2009/4
Y1 - 2009/4
N2 - Iron deficiency contributes to anemia after transplantation. The magnitude of iron loss from blood loss in the peri-transplantation period has not been quantified. We prospectively estimated phlebotomy and surgical losses over the first 12-weeks following transplantation in 39 consecutive renal transplant recipients on hemodialysis (HD), peritoneal dialysis (PD), or chronic kidney disease (CKD). At transplant, ferritin levels were <200 ng/ml in 51% of the patients, and iron saturation was ≤20% in 44%. CKD patients more commonly had ferritin levels <200 ng/ml than either HD or PD patients (100% vs. 21% vs. 67%, P < 0.0002, respectively). Blood loss was similar among HD, PD and CKD patients (833 ± 194 vs. 861 ± 324 vs. 755 ± 79 ml respectively, P = NS), and no difference between deceased and living donor transplant recipients (881 ± 291 vs. 788 ± 162 ml, P = 0.33). Based on baseline hemoglobin (Hgb) of 11.8 g/dl, we estimated that an additional 330 mg of iron was needed to normalize hemoglobin to 13 g/dl, and 605 mg to increase hemoglobin to 14 g/dl. Blood and iron losses over the first 12 weeks post-transplant are substantial and may warrant early administration of intravenous iron.
AB - Iron deficiency contributes to anemia after transplantation. The magnitude of iron loss from blood loss in the peri-transplantation period has not been quantified. We prospectively estimated phlebotomy and surgical losses over the first 12-weeks following transplantation in 39 consecutive renal transplant recipients on hemodialysis (HD), peritoneal dialysis (PD), or chronic kidney disease (CKD). At transplant, ferritin levels were <200 ng/ml in 51% of the patients, and iron saturation was ≤20% in 44%. CKD patients more commonly had ferritin levels <200 ng/ml than either HD or PD patients (100% vs. 21% vs. 67%, P < 0.0002, respectively). Blood loss was similar among HD, PD and CKD patients (833 ± 194 vs. 861 ± 324 vs. 755 ± 79 ml respectively, P = NS), and no difference between deceased and living donor transplant recipients (881 ± 291 vs. 788 ± 162 ml, P = 0.33). Based on baseline hemoglobin (Hgb) of 11.8 g/dl, we estimated that an additional 330 mg of iron was needed to normalize hemoglobin to 13 g/dl, and 605 mg to increase hemoglobin to 14 g/dl. Blood and iron losses over the first 12 weeks post-transplant are substantial and may warrant early administration of intravenous iron.
KW - Anemia
KW - Iron deficiency
KW - Renal transplantation
UR - http://www.scopus.com/inward/record.url?scp=61849117242&partnerID=8YFLogxK
U2 - 10.1111/j.1432-2277.2008.00814.x
DO - 10.1111/j.1432-2277.2008.00814.x
M3 - Article
C2 - 19076330
AN - SCOPUS:61849117242
SN - 0934-0874
VL - 22
SP - 434
EP - 440
JO - Transplant International
JF - Transplant International
IS - 4
ER -