P Przybyłowski, J Małyszko, J Małyszko
Ann Transplant 2009; 14(1): 66-66
Cardiovascular disease and kidney disease are like Siamese twins sharing
similar characteristics. It has been recently recognized that many patients with cardiovascular disease are anaemic. The anaemia is very often associated with kidney dysfunction. Even, the term cardio-renal anaemia syndrome was endorsed to stress the dangerous associations. The aim of the study was to assess prevalence of anaemia in relation to chronic kidney disease in 162
consecutive patients after heart transplantation. According to WHO's definition (haemoglobin less than 13 g/dl for males and less than 12 g/dl for females) prevalence of anaemia in the studied cohort was 41%. Anaemic patients had significantly lower GFR (MDRD and Cockcroft-Gault 44.46±26.84 ml/min vs. 62.70±24.15 ml/min, and 48.93±27.80 ml/min vs. 72.11±29.76 ml/min, p<0.001 respectively), creatinine clearance, lower RBC, haemoglobin, ejection fraction and significantly higher creatinine, NT-proBNP. Presence of anaemia was related to the time after transplantation, GFR, creatinine clearance, creatinine, NT-proBNP, cholesterol, ejection fraction. In multiple regression analysis the only predictor of anaemia was the kidney function (GFR or creatinine clearance) explaining 22% of the variation. Type of immunosuppressive regimen (CNI vs. mTOR inhibitors vs. MMF) did not affect prevalence of anaemia in this studied population. Prevalence of anaemia is relatively high in population of heart allograft recipients and not adequately treated (mainly due to reimbursement regulations). In patients with cardiovascular disease, GFR should be estimated since renal dysfunction and subsequent anaemia are the ones of more important risk for cardiovascular morbidity and mortality. It should be noted also that chronic heart failure is also more common in anaemic patients.
Keywords: Heart Transplantation