Post‐kidney transplantation erythrocytosis and its relationship to renal artery stenosis, IGF‐1, and its binding protein 3 (IGFBP‐3)

Abstract

Background Erythrocytosis is relatively common following kidney transplantation. It increases the risk of thromboembolism. Insulin‐like growth factor‐1 (IG‐1) and its binding protein 3 (IGFBP‐3) may play a role in its pathogenesis. Patients and Methods A total of 120 consecutive kidney‐transplanted patients with at least 3 month graft function were studied. Forty‐five kidney transplant patients were then selected and divided into 2 groups: 15 patients with post‐transplant erythrocytosis (PTE; group I), 30 without erythrocytosis (group II), and 15 healthy subjects matched with the cases as a control group (group III). Full medical history, clinical examination, hematological parameters, routine biochemical tests, IGF‐1, and IGFBP‐3 were measured in all subjects. Duplex ultrasonography for diagnosis of renal artery stenosis was done. Results Post‐transplant erythrocytosis developed with an incidence rate of 23.3%. The serum of IGF‐1 was significantly higher in the renal transplant recipients with and without erythrocytosis (309.4 ± 72.9, 301.6 ± 67.5 ng/mL, respectively) compared to controls (232.5 ± 95.3 ng/ml, p < 0.01), although there was no statistical difference between the first 2 groups. However, the serum of IGFBP‐3 was significantly higher in the renal transplant recipients with erythrocytosis than those without erythrocytosis and normal individuals (p < 0.001). Graft function and incidence of acute and chronic rejection were similar between the 2 groups. Conclusion Post‐transplant erythrocytosis represents an anomaly of IGF‐1 and its major binding proteins in which they may alter erythropoietin homeostatic mechanisms in the denervated transplant kidney which may be superimposed on a setting of multiple risk factors and leads to a state of erythrocytosis that is seen after kidney transplantation.

Risk factors and outcomes of post‐transplant erythrocytosis among adult kidney transplant recipients: a systematic review and meta‐analysis

“…A total of 61 studies underwent full-length article review; 22 were excluded, as they did not include controls or report the outcome of interest. A total of 39 observational studies [4,6,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47], including 7,099 patients, finally met our inclusion criteria and were included in the meta-analysis. Figure 1 outlines our search methodology and selection process; the baseline characteristics of the included studies are summarized in Table 1.…”

Frequency of Post-Transplant Erythrocytosis in Patients with Live Related Renal Transplant

“…In this study it was found that conditions like splenectomy, anemia or immunosuppression therapies have no role in causing Erythrocytosis. The prevalence of vascular diseases like diabetes shows that it can be linked with Erythrocytosis [15][16] . As per another study it was found that PTE prevalence was more in case of women as compared to men 17 .…”