Abstract
Introduction: Chronic kidney disease (CKD) is a major worldwide public health issue. Renal transplantation improves survival in end-stage CKD, but iron deficiency (ID) remains common, even in the absence of anemia, and may negatively impact kidney graft function and patient quality of life. Studies assessing the prevalence and associated factors of ID in kidney transplant recipients are rare.
Methods: We conducted a retrospective cohort study that included 104 adult renal transplant recipients followed at Gabriel Montpied University Hospital between January and December 2023. Iron deficiency and anemia were defined according to KDIGO guidelines, with iron deficiency as ferritin<100 µg/L and/or transferrin saturation (TSAT)<20%, and anemia thresholds corresponding to WHO criteria (hemoglobin<13 g/dL in men and<12 g/dL in women). We collected and analyzed clinical, biological, and therapeutic data. Multivariate logistic regression was performed to identify factors independently associated with iron deficiency.
Results: Thirty-six percent of patients had iron deficiency, independent of anemia, in a significant proportion. ID was positively associated with longer graft duration and basiliximab induction (OR 2.90, 95% CI 1.25–6.74, P=0.013), whereas thymoglobulin induction appeared protective (OR 0.37, 95% CI 0.16–0.85, P=0.019). Lower serum iron levels were also significantly associated with ID (OR 0.18, 95% CI 0.06–0.56, P=0.003).
Conclusion: Iron deficiency is common in kidney transplant recipients, even without anemia. Systematic screening and targeted management may improve graft outcomes and patient quality of life.Study Highlights: - Iron deficiency (ID) affected 36% of renal transplant patients. - ID occurred independently of anemia in a significant portion of patients. - Longer graft duration and use of basiliximab were positively associated with ID. - Thymoglobulin induction appeared to be protective against ID. - Routine iron status screening is recommended post-transplant.