#3003 Impact of Full Correction of Hemoglobin Among Post-Transplant Anemic Kidney Transplant Recipients: A Prospective Randomized Controlled Trial

Abstract

Background and Aims Several studies have shown that post-transplant anemia (PTA) might be associated with increased mortality and decreased graft survival and de-novo congestive heart failure. So we aimed from this prospective randomized controlled study to assess the impact of full correction of PTA on the cardiovascular system of renal transplant recipients receiving erythropoietin stimulating agents (ESA). Method We recruited 247 kidney recipients with stable graft function in this RCT with 2 groups according to their target hemoglobin (11-12 g/dl, group 1, n=183) and (13:15 g/dl, group 2, n=64). After correction of deficiencies, the target hemoglobin was achieved using ESA. All patients were followed up clinically and Laboratory and radiologically for 12 months. Results Diabetic nephropathy was the main cause of ESKD in group 1. The studied groups were comparable regarding pre-transplant co-morbidities. Most patients received thymoglobulin as induction then cyclosporine based maintenance immunosuppression. We did not find any significant difference between the two groups concerning post-transplant diabetes, BK viremia or malignancies and even cardiovascular events (TIA, stroke, ACS), (p>0.05). Group 1 showed higher mean blood pressure (P = .003), lower LV internal dimensions, higher LVH, LV mass, IVSD and LV mass index after one year of the study (p< 0.05). MIVSD, mean ejection fraction and FS were comparable in both groups (p>0.05). Graft outcome was comparable between both groups (P = .125), meanwhile mortality cases were significantly higher among group 1 (16 cases, 8.7%) (P = .005). Conclusion Full correction of PTA is associated with stabilized cardiac dimensions indices without any significant cardiovascular comorbidities.