Higher Hemoglobin Levels, Better Graft Function Linked

NEW ORLEANS—Kidney transplant recipients with post-transplant anemia should be managed to a higher hemoglobin (Hb) target to promote graft survival, suggests a new study presented at Kidney Week 2017.

In a randomized controlled trial, Makoto Tsujita, MD, of Nagoya Daini Red Cross Hospital in Japan, and colleagues assigned 126 recipients (mean age 50 years) with stable renal grafts to either normal Hb (12.5–13.5 g/dL) or abnormal Hb (10.5–11.5 g/dL) targets. Darbepoetin alfa or epoetin beta was used for therapy.

Both groups were successfully managed to their respective target Hb levels. Mean Hb levels rose from 11.3 and 11.2 g/dL at baseline to 12.6 and 11.2 g/dL at 24 months, for the normal and abnormal Hb groups, respectively.

Graft function differed between groups. Estimated glomerular filtration rate (eGFR) declined from 35.4 and 35.9 mL/min/1.73m² at baseline to 34.8 and 32.7 mL/min/1.73m² at 24 months, in the normal and abnormal Hb groups, respectively. The mean eGFR decrease was 0.1 and 3.7 mL/min/1.73m², respectively.

With regard to adverse effects, there was a single case of pulmonary embolism with full recovery. Blood pressure increased in 2 cases. None of the patients experienced doubling of serum creatinine levels or end-stage renal disease. No patients experienced acute rejection or a cardiovascular event.

“This study shows that high Hb values might be more impactful on graft function in Japanese kidney transplant recipients,” Dr Tsujita concluded. “Mean Hb levels in the Hb normal [group] didn’t reach target range within 3 months, and more than 12 months were needed.”

Tsujita M. High hemoglobin levels maintain graft function in Japanese kidney transplant recipients. Presented at: Kidney Week 2017. October 31-November 5, 2017. New Orleans. Abstract TH-PO944.