Factors Associated with Post-Transplant Anemia among Renal Transplant Recipients with Functioning Grafts in Sana’a City, Yemen

Abstract

Objective:To assess the factors associated with anemia in renal transplant recipients with functioning grafts in Sana'a city, Yemen. Methods:One hundred and thirteen adult renal transplant recipients with functioning grafts were enrolled in this study in the period from Janury to December 2014. Biodata and clinical data were collected using a pre-designeddata collection sheet. Hemoglobin (Hb) concentration was measured, and anemia was defined as Hb concentration less than13.0 g/dLin males and less than 12.0 g/dL in females. The factors associated with anemia were analyzed, and independent predictors of post-transplant anemia (PTA) among renal transplant recipients were identified using a multivariable logistic regression model. Results: PTA was detected in 23.0% of renal transplant recipients with functioning grafts. Bivariate analysis showed a significant association of PTA with age of 50 years or older (Odds ratio (OR) = 2.7; 95% CI: 1.10-6.72; P = 0.03), history of acute rejection (OR = 3.6; 95% CI: 1.17-11.28; P = 0.019) and delayed graft function (OR = 6.2; 95% CI:1.60-24.16; P = 0.004). Multivariable analysis using a logistic regression model identified history of acute rejection (adjusted OR = 3.9; 95% CI: 1.11-12.94; P = 0.034) and delayed graft function (adjusted OR = 4.6; 95% CI: 1.07-19.81; P = 0.04) as independent risk factors for PTA among recipients. However, no association was found between PTA and recipient's gender, graft source, immunosuppressive protocols, erythropoietin treatment or use of antihypertensive drugs. Conclusions:The prevalence of PTA among Yemeni renal transplant recipients is high, with history of acute rejection and delayed graft function being the independent risk factors. Therefore, it is recommended that physicians involved in renal transplantation consider the investigation and follow-up of transplant recipients for PTA and adopt appropriate preventive and therapeutic measures.