ANEMIA FOLLOWING RENAL-TRANSPLANTATION - ERYTHROPOIETIN RESPONSE AND IRON-DEFICIENCY

To define the etiology of anemia post-renal transplantion, we assessed hematologic parameters and EPO levels in 38 anemic and 16 nonanemic c ontrol renal transplant recipients (RTRs) with varying degrees of allo graft function at periods >3 months post-transplantation. Significant differences between the two groups were found for serum creatinine (Cr ) 291.7+/-26.5 vs. 203.3+/-26.5 mu mol/l, p<0.01; iron 9.3+/-0.92 vs. 13.6+/-1.7 mu mol/l, p<0.05; and ferritin 345.5+/-90.8 vs. 91.1+/-18.5 mu g/l, p<0.01. Serum EPO levels were inappropriately low in anemic p atients with no significant correlation between EPO and Cr or hematocr it (Hct) levels. Serum iron was the only predictive factor for anemia on regression analysis (p<0.05). Ferritin levels did not correlate wit h serum iron or Hct, and may be falsely elevated in iron deficient RTR s. Iron deficiency, poor renal function and inappropriately low EPO le vels are major contributors to the 12% of our outpatient renal transpl ant population who are anemic.