Open AccessIron deficiency anemia and iron losses after renal transplantation
Author(s) -
Zheng Sijie,
Coyne Daniel W.,
Joist Heidi,
Schuessler Rebecca,
GodboldoBrooks Ambyr,
Ercole Patrick,
Brennan Daniel C.
Publication year - 2009
Publication title -
transplant international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.998
H-Index - 82
eISSN - 1432-2277
pISSN - 0934-0874
DOI - 10.1111/j.1432-2277.2008.00814.x
Subject(s) - medicine , hemoglobin , transplantation , anemia , peritoneal dialysis , phlebotomy , gastroenterology , kidney disease , ferritin , hemodialysis , iron deficiency , kidney transplantation , transferrin saturation , dialysis , surgery , urology
Summary 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.