Anemia in Pediatric Kidney Transplant Recipients—Etiologies and Management

• Published in: Frontiers in pediatrics Vol. 10; p. 929504
• Main Authors: Kouri, Anne, Balani, Shanthi, Kizilbash, Sarah
• Format: Journal Article
• Language: English
• Published: Frontiers Media S.A 20.06.2022
• Subjects: anemia; erythropoietin; hepcidin; iron deficiency; pediatric kidney transplant; Pediatrics
• ISSN: 2296-2360; 2296-2360
• DOI: 10.3389/fped.2022.929504

Posttransplant anemia (PTA) is a common complication of pediatric kidney transplantation, with a prevalence ranging from 22 to 85%. PTA is categorized as early (within 6 months posttransplant) and late (>6 months posttransplant). Early PTA is typically associated with surgical blood losses and iron deficiency. Late PTA primarily results from graft dysfunction; however, iron deficiency, drug toxicity, and posttransplant inflammation also play a role. PTA is more severe compared with the anemia in glomerular-filtration-rate matched patients with native chronic kidney disease. Treatment of PTA is directed toward the underlying cause. Erythropoiesis stimulating agents (ESA) are effective; however, their use is limited in the transplant setting. Timely diagnosis and treatment of PTA are vital to prevent long-term adverse outcomes in pediatric transplant recipients.