Iron Deficiency After Kidney Transplantation

Joanna Sophia J. Vinke; Marith I. Francke; Michele F. Eisenga; Dennis A. Hesselink; Martin H. de Borst


Nephrol Dial Transplant. 2021;36(11):1976-1985. 

In This Article

Iron and Allograft Outcomes

Patient data on iron status in relation to kidney allograft outcomes are scarce. A retrospective cohort study in 169 KTRs showed that a higher ferritin concentration was associated with better graft function and graft survival.[34] In contrast, a cohort study in 438 KTRs found no association between the percentage of hypochromic red blood cells (HRBCs) and graft failure, although there was a trend towards greater graft survival among KTR who received iron therapy at baseline [hazard ratio (HR) = 0.51, 95% confidence interval (CI) 0.24–1.09; P = 0.08].[3] In a mouse heart transplant model, ID decreased allograft survival due to more severe rejection.[77] In contrast, a prolonged pancreatic islet or heart allograft survival was observed in rodents following either anti-transferrin receptor (TfR) antibody treatment or iron chelation therapy.[78–80] While clinical data on the effect of ID on kidney allograft outcomes are limited, more is known on the impact of iron (deficiency) on the immune system in general.