Serum erythropoietin level and mortality in kidney transplant recipients

Miklos Z. Molnar, Adam G. Tabak, Ahsan Alam, Maria E. Czira, Anna Rudas, Akos Ujszaszi, Gabriella Beko, Marta Novak, Kamyar Kalantar-Zadeh, Csaba Kovesdy, Istvan Mucsi

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Background and objectives Posttransplant anemia is frequently reported in kidney transplant recipients and is associated with worsened patient survival. Similar to high erythropoiesis-stimulating agent requirements, resistance to endogenous erythropoietin may be associated with worse clinical outcomes in patients with ESRD. We examined the association between serum erythropoietin levels and mortality among kidney transplant recipients. Design, setting, participants, & measurements We collected sociodemographic, clinical, medical, and transplant history and laboratory data at baseline in 886 prevalent kidney transplant recipients (mean age 51 ± 13 [SD] years, 60% men, 21% diabetics). A solid-phase chemiluminescent immunometric assay was used to measure serum erythropoietin. Cox proportional hazards regression was used to model the association between baseline serum erythropoietin levels and all-cause mortality risk. Results During the median 39-month follow-up, 99 subjects died. The median serum erythropoietin level was 10.85 U/L and hemoglobin was 137 ± 16 g/L. Mortality rates were significantly higher in patients with higher erythropoietin levels (crude mortality rates in the highest to lowest erythropoietin tertiles were 51.7, 35.5, and 24.0 per 1000 patient-years, respectively [P = 0.008]). In unadjusted and also in adjusted Cox models each SD higher serum erythropoietin level significantly predicted all-cause mortality: HR 1SD increase 1.22 and 1.28, respectively. In adjusted Cox models each SD higher serum erythropoietin/blood hemoglobin ratio also significantly predicted all-cause mortality: HR 1SD increase 1.32. Serum erythropoietin predicted mortality in all analyzed subgroups. Conclusions In this sample of prevalent kidney transplant recipients, higher serum erythropoietin levels were associated with increased mortality.

Original languageEnglish (US)
Pages (from-to)2879-2886
Number of pages8
JournalClinical Journal of the American Society of Nephrology
Volume6
Issue number12
DOIs
StatePublished - Dec 1 2011

Fingerprint

Erythropoietin
Kidney
Mortality
Serum
Proportional Hazards Models
Hemoglobins
Transplant Recipients
Hematinics
Luminescent Measurements
Chronic Kidney Failure
Anemia
History
Transplants
Survival

All Science Journal Classification (ASJC) codes

  • Epidemiology
  • Critical Care and Intensive Care Medicine
  • Nephrology
  • Transplantation

Cite this

Molnar, M. Z., Tabak, A. G., Alam, A., Czira, M. E., Rudas, A., Ujszaszi, A., ... Mucsi, I. (2011). Serum erythropoietin level and mortality in kidney transplant recipients. Clinical Journal of the American Society of Nephrology, 6(12), 2879-2886. https://doi.org/10.2215/CJN.05590611

Serum erythropoietin level and mortality in kidney transplant recipients. / Molnar, Miklos Z.; Tabak, Adam G.; Alam, Ahsan; Czira, Maria E.; Rudas, Anna; Ujszaszi, Akos; Beko, Gabriella; Novak, Marta; Kalantar-Zadeh, Kamyar; Kovesdy, Csaba; Mucsi, Istvan.

In: Clinical Journal of the American Society of Nephrology, Vol. 6, No. 12, 01.12.2011, p. 2879-2886.

Research output: Contribution to journalArticle

Molnar, MZ, Tabak, AG, Alam, A, Czira, ME, Rudas, A, Ujszaszi, A, Beko, G, Novak, M, Kalantar-Zadeh, K, Kovesdy, C & Mucsi, I 2011, 'Serum erythropoietin level and mortality in kidney transplant recipients', Clinical Journal of the American Society of Nephrology, vol. 6, no. 12, pp. 2879-2886. https://doi.org/10.2215/CJN.05590611
Molnar, Miklos Z. ; Tabak, Adam G. ; Alam, Ahsan ; Czira, Maria E. ; Rudas, Anna ; Ujszaszi, Akos ; Beko, Gabriella ; Novak, Marta ; Kalantar-Zadeh, Kamyar ; Kovesdy, Csaba ; Mucsi, Istvan. / Serum erythropoietin level and mortality in kidney transplant recipients. In: Clinical Journal of the American Society of Nephrology. 2011 ; Vol. 6, No. 12. pp. 2879-2886.
@article{5dbf9b2eca24428d9ef799d427ba7f23,
title = "Serum erythropoietin level and mortality in kidney transplant recipients",
abstract = "Background and objectives Posttransplant anemia is frequently reported in kidney transplant recipients and is associated with worsened patient survival. Similar to high erythropoiesis-stimulating agent requirements, resistance to endogenous erythropoietin may be associated with worse clinical outcomes in patients with ESRD. We examined the association between serum erythropoietin levels and mortality among kidney transplant recipients. Design, setting, participants, & measurements We collected sociodemographic, clinical, medical, and transplant history and laboratory data at baseline in 886 prevalent kidney transplant recipients (mean age 51 ± 13 [SD] years, 60{\%} men, 21{\%} diabetics). A solid-phase chemiluminescent immunometric assay was used to measure serum erythropoietin. Cox proportional hazards regression was used to model the association between baseline serum erythropoietin levels and all-cause mortality risk. Results During the median 39-month follow-up, 99 subjects died. The median serum erythropoietin level was 10.85 U/L and hemoglobin was 137 ± 16 g/L. Mortality rates were significantly higher in patients with higher erythropoietin levels (crude mortality rates in the highest to lowest erythropoietin tertiles were 51.7, 35.5, and 24.0 per 1000 patient-years, respectively [P = 0.008]). In unadjusted and also in adjusted Cox models each SD higher serum erythropoietin level significantly predicted all-cause mortality: HR 1SD increase 1.22 and 1.28, respectively. In adjusted Cox models each SD higher serum erythropoietin/blood hemoglobin ratio also significantly predicted all-cause mortality: HR 1SD increase 1.32. Serum erythropoietin predicted mortality in all analyzed subgroups. Conclusions In this sample of prevalent kidney transplant recipients, higher serum erythropoietin levels were associated with increased mortality.",
author = "Molnar, {Miklos Z.} and Tabak, {Adam G.} and Ahsan Alam and Czira, {Maria E.} and Anna Rudas and Akos Ujszaszi and Gabriella Beko and Marta Novak and Kamyar Kalantar-Zadeh and Csaba Kovesdy and Istvan Mucsi",
year = "2011",
month = "12",
day = "1",
doi = "10.2215/CJN.05590611",
language = "English (US)",
volume = "6",
pages = "2879--2886",
journal = "Clinical journal of the American Society of Nephrology : CJASN",
issn = "1555-9041",
publisher = "American Society of Nephrology",
number = "12",

}

TY - JOUR

T1 - Serum erythropoietin level and mortality in kidney transplant recipients

AU - Molnar, Miklos Z.

AU - Tabak, Adam G.

AU - Alam, Ahsan

AU - Czira, Maria E.

AU - Rudas, Anna

AU - Ujszaszi, Akos

AU - Beko, Gabriella

AU - Novak, Marta

AU - Kalantar-Zadeh, Kamyar

AU - Kovesdy, Csaba

AU - Mucsi, Istvan

PY - 2011/12/1

Y1 - 2011/12/1

N2 - Background and objectives Posttransplant anemia is frequently reported in kidney transplant recipients and is associated with worsened patient survival. Similar to high erythropoiesis-stimulating agent requirements, resistance to endogenous erythropoietin may be associated with worse clinical outcomes in patients with ESRD. We examined the association between serum erythropoietin levels and mortality among kidney transplant recipients. Design, setting, participants, & measurements We collected sociodemographic, clinical, medical, and transplant history and laboratory data at baseline in 886 prevalent kidney transplant recipients (mean age 51 ± 13 [SD] years, 60% men, 21% diabetics). A solid-phase chemiluminescent immunometric assay was used to measure serum erythropoietin. Cox proportional hazards regression was used to model the association between baseline serum erythropoietin levels and all-cause mortality risk. Results During the median 39-month follow-up, 99 subjects died. The median serum erythropoietin level was 10.85 U/L and hemoglobin was 137 ± 16 g/L. Mortality rates were significantly higher in patients with higher erythropoietin levels (crude mortality rates in the highest to lowest erythropoietin tertiles were 51.7, 35.5, and 24.0 per 1000 patient-years, respectively [P = 0.008]). In unadjusted and also in adjusted Cox models each SD higher serum erythropoietin level significantly predicted all-cause mortality: HR 1SD increase 1.22 and 1.28, respectively. In adjusted Cox models each SD higher serum erythropoietin/blood hemoglobin ratio also significantly predicted all-cause mortality: HR 1SD increase 1.32. Serum erythropoietin predicted mortality in all analyzed subgroups. Conclusions In this sample of prevalent kidney transplant recipients, higher serum erythropoietin levels were associated with increased mortality.

AB - Background and objectives Posttransplant anemia is frequently reported in kidney transplant recipients and is associated with worsened patient survival. Similar to high erythropoiesis-stimulating agent requirements, resistance to endogenous erythropoietin may be associated with worse clinical outcomes in patients with ESRD. We examined the association between serum erythropoietin levels and mortality among kidney transplant recipients. Design, setting, participants, & measurements We collected sociodemographic, clinical, medical, and transplant history and laboratory data at baseline in 886 prevalent kidney transplant recipients (mean age 51 ± 13 [SD] years, 60% men, 21% diabetics). A solid-phase chemiluminescent immunometric assay was used to measure serum erythropoietin. Cox proportional hazards regression was used to model the association between baseline serum erythropoietin levels and all-cause mortality risk. Results During the median 39-month follow-up, 99 subjects died. The median serum erythropoietin level was 10.85 U/L and hemoglobin was 137 ± 16 g/L. Mortality rates were significantly higher in patients with higher erythropoietin levels (crude mortality rates in the highest to lowest erythropoietin tertiles were 51.7, 35.5, and 24.0 per 1000 patient-years, respectively [P = 0.008]). In unadjusted and also in adjusted Cox models each SD higher serum erythropoietin level significantly predicted all-cause mortality: HR 1SD increase 1.22 and 1.28, respectively. In adjusted Cox models each SD higher serum erythropoietin/blood hemoglobin ratio also significantly predicted all-cause mortality: HR 1SD increase 1.32. Serum erythropoietin predicted mortality in all analyzed subgroups. Conclusions In this sample of prevalent kidney transplant recipients, higher serum erythropoietin levels were associated with increased mortality.

UR - http://www.scopus.com/inward/record.url?scp=83155182221&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=83155182221&partnerID=8YFLogxK

U2 - 10.2215/CJN.05590611

DO - 10.2215/CJN.05590611

M3 - Article

VL - 6

SP - 2879

EP - 2886

JO - Clinical journal of the American Society of Nephrology : CJASN

JF - Clinical journal of the American Society of Nephrology : CJASN

SN - 1555-9041

IS - 12

ER -