Hematologic findings and value of value of endogenous creatinine in patients following kidney transplantation

We have studied serum erythropoietin (EPO) levels, serum creatinine and blood hemoglobin and hematocrit levels in the group of 140 patients after kidney transplantation. All patients received conventional immunosuppressive therapy consisting of cyclosporine (Sandimmune Neoral), azathioprin (Imuran) and steroids (Prednison). The aim of the study was to investigate the relationship between serum EPO, serum creatinine and hematologic parameters. Complete restoration of hemoglobin and hematocrit levels was obtained in 99 patients (70.7%), moderate degree of anaemia with average hemoglobin level 114.7 +/- 12.3 g/l was seen in 37 patients (26.4%) and four patients (2.9%) had posttransplant erythrocytosis. Normal hemoglobin values are generally restored during 3 months after successful renal transplantation. Statistical analysis confirmed significant correlation (p < 0.001) between graft function and hematologic parameters, but none correlation was found neither between serum EPO levels and serum creatinine and not between serum EPO levels and hemoglobin/hematocrit values. Plasma creatinine is not reliable indicator of renal EPO secretory capacity. The degree of correction of anemia is limited by the stage of graft function and correlates with the serum creatinine concentration. The results suggest, that the restoration of normal excretory graft function after transplantation improves bone marrow response to EPO and leads to normalization of erythropoietic activity.