Introduction: Post-kidney transplant erythrocytosis (PTE) is a common complication after kidney transplant, which can occur in 8-15% of transplant recipients. However, this condition, including the Thai population, has not been well studied in Southeast Asia.

Method: A single-center retrospective cohort was conducted among adult kidney transplant recipients who underwent transplantation between January 2010 and December 2020. Erythrocytosis is defined by hemoglobin levels > 16.5 g/dl in males and > 16.0 g/dl in females. We assessed the incidence and risk factors of PTE in this cohort and compared outcomes of PTE versus non-PTE patients.

Results: Of 399 kidney transplants, 84 (21%) developed PTE over a total follow-up time of 5.06 ± 2.16 years. The mean age was 44.36 ± 10.59 years, with 57.1% of male subjects. All PTE patients were asymptomatic during the clinical course of PTE. The median duration of PTE was 8.83 (5.55 - 18.17) months. In the multivariable analysis, male subjects were at a 1.92-time higher risk for PTE development than females (HR 1.92; 95%CI 1.16-3.20). Patients with pre-existing polycystic kidney disease (PKD) had a 3.87-time higher risk of developing PTE compared to those without PKD (HR 3.87; 95%CI 1.50-9.98). PTE patients significantly had a 50% lower risk for composite outcomes, including infection, new onset diabetes, transplant rejection, dialysis dependence, and death, compared to non-PTE groups (HR 0.50; 95%CI 0.27 - 0.9). Interestingly, none of the PTE patients underwent renal replacement therapy throughout the observation, while some non-PTE individuals became dialysis dependent.

Conclusion: Our study revealed the incidence rate of PTE was 0.05/person-year. PTE in Thai patients was strongly associated with male gender and pre-existing PKD. Patients with PTE tended to have higher eGFR. They had a significantly lower risk of developing composite outcomes, including infection, new-onset diabetes, rejection episodes, dialysis dependence, and mortality, compared to those without PTE.

Disclosures

No relevant conflicts of interest to declare.

This content is only available as a PDF.
2024
Sign in via your Institution