uu.seUppsala University Publications
Change search
ReferencesLink to record
Permanent link

Direct link
Incidence of anemia in sirolimus-treated renal transplant recipients: the importance of preserving renal function
Show others and affiliations
2007 (English)In: Transplant International, ISSN 0934-0874, E-ISSN 1432-2277, Vol. 20, no 9, 754-760 p.Article in journal (Refereed) Published
Abstract [en]

Sirolimus (SRL) has a concentration-related effect on hematopoiesis. In this study, 430 renal transplant recipients were randomized (1:1) 3 months post-transplantation to continue SRL-cyclosporine (CsA)-steroids (ST) or to have CsA withdrawn (SRL-ST). Over 5 years, on therapy calculated glomerular filtration rate (GFR), hematological indices, erythropoietin (EPO) use, and rates of mild, moderate, and severe anemia were determined. Longitudinal analyses using linear mixed models examined covariates predicting hemoglobin (Hgb) levels. Mean Hgb was significantly lower with SRL-ST at 6 months; but subsequently became significantly higher (at 2 years, 129 vs. 135 g/l, SRL-CsA-ST vs. SRL-ST, P<0.001). Mean corpuscular volume was low with both therapies, and significantly lower with SRL-ST. EPO use was similar in the two groups, approximately 30% during the first year and 10% thereafter. The incidence of anemia was significantly higher with SRL-CsA-ST>or=2 years. At year 5, only 39.1% of SRL-CsA-ST patients had normal Hgb vs. 68.5% of SRL-ST patients. GFR and recipient age as well as the interaction term x treatment time were significant covariates predicting Hgb. CsA withdrawal followed by SRL immunotherapy resulted in significantly less anemia than SRL-CsA-ST, despite twofold higher SRL exposure. This suggests that the improvement in GFR accompanying CsA withdrawal may mitigate the effect of SRL on hematopoiesis. (ClinicalTrials.gov number: NCT00428064).

Place, publisher, year, edition, pages
2007. Vol. 20, no 9, 754-760 p.
Keyword [en]
anemia, cyclosporine withdrawal, hemoglobin, kidney transplantation, renal function, sirolimus
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-103336DOI: 10.1111/j.1432-2277.2007.00506.xISI: 000249200700003PubMedID: 17565578OAI: oai:DiVA.org:uu-103336DiVA: diva2:218065
Available from: 2009-05-19 Created: 2009-05-19 Last updated: 2015-06-15Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full textPubMed

Search in DiVA

By author/editor
Tufveson, Gunnar
By organisation
Transplantation Surgery
In the same journal
Transplant International
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar

Altmetric score

Total: 207 hits
ReferencesLink to record
Permanent link

Direct link