Comparative Effects of Sirolimus and Mycophenolate Mofetil on Erythropoiesis in Kidney Transplant Patients

https://doi.org/10.1111/j.1600-6143.2004.00612.xGet rights and content
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Anemia and erythrocytosis (PTE) are common after kidney transplantation. We sought to determine the influence of sirolimus compared to mycophenolate mofetil (MMF) on post-transplant erythropoiesis.

A total of 214 patients with recent kidney or kidney–pancreas transplants were treated with either sirolimus-based (n = 87) or MMF-based (n = 127) therapy. At 12 months, the prevalence of anemia was 31% with MMF and 57% with sirolimus (p < 0.001). Linear regression was used to examine the independent influence of sirolimus on hemoglobin at 12 months, controlling for multiple factors including gender and renal function. Sirolimus remained a significant correlate of lower hemoglobin in all patients (slope =−1.060, 95% CI: −1.76 to −0.362, p = 0.003), and in patients without PTE (slope =−0.671, 95% CI: −1.32 to −0.028, p = 0.041).

PTE, defined as a persistent hematocrit above 51%, occurred in 19% with MMF and 7% with sirolimus (p = 0.013). PTE was examined using logistic regression analysis. Sirolimus use correlated negatively with PTE (odds ratio with sirolimus = 0.33, 95% CI: 0.12 to 0.89, p = 0.028).

Our results indicate that, compared to treatment with MMF, treatment of kidney or kidney–pancreas recipients with sirolimus is associated with a higher prevalence of anemia, lower hemoglobin levels and lower incidence of PTE.

Keywords

Renal transplantation
side effects
anemia
sirolimus
mycophenolate mofetil
post transplant erythrocytosis

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