Treatment of Anemia With Epoetin in Kidney Transplant Recipients Andrej Bren, Miha Arnol, Aljoša Kandus, Janez Varl, Manca Oblak, Jelka Lindic ˇ, Jernej Pajek, Bojan Knap, Damjan Kovac ˇ, Gregor Mlinšek, and Jadranka Buturovic ´-Ponikvar Department of Nephrology, University Medical Center Ljubljana, Ljubljana, Slovenia Abstract: The aim of this study was to analyze the preva- lence and efficacy of renal anemia treated with epoetin in maintenance kidney transplant recipients in Slovenia. By the end of 2009, 107 out of 537 patients (19.9%) had been treated with epoetin. A cohort of 49 patients (45.8%) were analyzed in detail: 11 patients received epoetin alfa, 18 epoetin beta, 10 darbepoetin alfa, and 10 patients received methoxy polyethylene glycol-epoetin beta. The median epoetin dose was 0.36 mg/kg body weight per week. The median serum laboratory parameters were as follows: hemoglobin 120 g/L, hematocrit 0.36, ferritin 332 ng/mL, transferrin saturation 34%, serum creatinine 145 mmol/L, serum albumin 41 g/L, intact parathyroid hormone 79 ng/L, and C-reactive protein 3 mg/L. We concluded that the prevalence of renal anemia in kidney transplant recipients treated with epoetin was approximately 20%, and labora- tory parameters suggested that the treatment of renal anemia in this study cohort was optimal. Key Words: Anemia, Epoetin, Kidney transplantation. Anemia is a common phenomenon after kidney transplantation, is frequently undertreated, and has received comparatively less attention than other pathologies in the literature (1). During the early post-transplantation period lasting up to six months, anemia occurs in up to 76% of patients (2,3). Some studies have reported an incidence of anemia that approached 40% at one year post-transplant (4). The prevalence of post-transplant anemia after the first year ranges from 20% to 60%, depending on the definition of anemia, graft function, immunosuppres- sive protocol, and serum erythropoietin levels (4–7). Although some studies have shown that post- transplant anemia was associated with worse patient and graft survival and higher rates of acute rejection when compared with non-anemic kidney transplant recipients, others pointed out that there is a shortage of well-conducted prospective studies looking at the morbidity attributable to post-transplant anemia, as well as a lack of trial evidence to determine whether intervention improves patient morbidity and outcome (1,8). Some authors reported no clinically relevant advantage of anemia treatment in the early post-transplant period; however, during the mainte- nance phase after transplantation, renal anemia is easily corrected by epoetin therapy (9,10). The aim of our study was to analyze the prevalence and efficacy of anemia treatment with epoetin in kidney transplant recipients in Slovenia. PATIENTS AND METHODS The laboratory data for hemoglobin, hematocrit, serum creatinine, ferritin, transferrin saturation (TSAT), serum albumin, intact parathyroid hormone (iPTH), and C-reactive protein (CRP) were collected for the last three months of 2009. Among 537 patients with a functional kidney transplant, 107 (19.9%) were treated with epoetin due to renal anemia. In this study, a cohort of 49 stable patients (45.8%) (23 men and 26 women, aged 22–76 [mean 53  14] years) Received March 2011. Address correspondence and reprint requests to Dr Andrej Bren, Department of Nephrology, University Medical Center Ljubljana, Zaloška cesta 7, 1525 Ljubljana, Slovenia. Email: andrej.bren@kclj.si Presented in part at the Symposium Celebrating the 40th Anni- versary of Chronic Dialysis and Kidney Transplantation in Slovenia held 4–5 November 2010 in Bled, Slovenia. Therapeutic Apheresis and Dialysis 15(3):257–260 doi: 10.1111/j.1744-9987.2011.00947.x © 2011 The Authors Therapeutic Apheresis and Dialysis © 2011 International Society for Apheresis 257