Prevalence and management of anemia in renal transplant recipients: A European survey

Yves Vanrenterghem, Claudio Ponticelli, José María Morales, Daniel Abramowicz, Keshwar Baboolal, Björn Eklund, Volker Kliem, Christophe Legendre, Antonio Luis Morais Sarmento, Flavio Vincenti

Research output: Contribution to journalArticlepeer-review


The TRansplant European Survey on Anemia Management (TRESAM) documented the prevalence and management of anemia in kidney transplant recipients. Data from 72 transplant centers in 16 countries were screened, involving 4263 patients who had received transplants 6 months, 1, 3 or 5 years earlier. The mean age of transplant recipients was 45.5 years at transplantation. The most common etiology was chronic glomerulonephritis. The most common comorbidities were coronary artery disease, hepatitis B/C, and type 2 diabetes. The mean hemoglobin levels before transplantation were significantly higher in the more recently transplanted recipients. At enrollment, 38.6% of patients were found to be anemic. Of the 8.5% of patients who were considered severely anemic, only 17.8% were treated with epoetin. There was a strong association between hemoglobin and graft function; of the 904 patients with serum creatinine >2 mg/dL, 60.1% were anemic, vs. 29.0% of those with serum creatinine ≤2mg/dL (p <0.01). Therapy with angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor antagonists, mycophenolate mofetil (MMF) or azathioprine was also associated with a higher likelihood of anemia. The prevalence of anemia in the transplant recipients was remarkably high and appeared to be associated with impaired renal function and with ACE inhibitors and angiotensin II receptor antagonist use. Further studies should be carried out to interpret whether appropriate management of anemia after kidney transplantation may improve long-term outcome.

Original languageEnglish
Pages (from-to)835-845
Number of pages11
JournalAmerican Journal of Transplantation
Issue number7
Publication statusPublished - Jul 2003


  • Anemia
  • Chronic kidney disease
  • Epoetin
  • Hemoglobin
  • Immunosuppressive treatment
  • Kidney transplantation

ASJC Scopus subject areas

  • Immunology


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