Efficacy of erythropoietin administration in the treatment of anemia immediately after renal transplantation.

Anemia negatively impacts cardiovascular comorbidity and hospitalization. In animals, recombinant erythropoietin (RhuEPO) leads to faster recovery after acute tubular necrosis. This study evaluates the effect of RhuEPO (Recormon, Hoffinan-La Roche, Basel, Switzerland) on the correction of anemia and kidney function after renal transplantation. Patients receiving a renal transplant were randomized to receive or not receive RhuEPO 100 U/kg three times per week if the hemoglobin (Hb) level was less than 12.5 g/dL. The time to reach an Hb level greater than 12.5 g/dL was 66.5 +/- 14.5 days versus 52.6 +/- 23.7 days in the non-EPO and EPO groups, respectively (P = 0.05). After 3 months, Hb levels were not different between the non-EPO and EPO groups (12.6 +/- 1.5 g/dL vs. 12.0 +/- 1.5 g/dL, respectively), although there was a higher increase in the EPO group (4.1 +/- 1.1 g/dL vs. 3.2 +/- 1.1 g/dL, P = 0.02). In a Cox regression analysis, EPO use (relative risk 7.2, P = 0.004) and dose (relative risk = 0.63, P = 0.04) were retained as independent variables predicting the time to reach an Hb level greater than 12.5 g/dL. In the EPO group, 14 of 22 patients reached the target Hb level of more than 12.5 g/dL versus 12 of 18 patients in the non-EPO group (P = not significant). Serum creatinine levels were not different between groups. RhuEPO in the immediate posttransplantation period seems to have no relevant clinical impact on the correction of anemia. There was no difference in the evolution of serum creatinine levels. In view of the cost, the use of RhuEpo in the posttransplantation period should be limited to high-risk patients.