Biography
Biography: Padmanabhan Subramanian
Abstract
The factors that contribute to the correction of anemia of Chronic Kidney Disease (CKD) after successful renal transplantation include the production of erythropoietin (EPO) from the allograft and elimination for bonemarrow inhibitors which are present in the uremic milieu. Usually, anemia gets corrected by the 3rd post-transplant month. About 20% of the renal allograft recipients develop persistent high hematocrit of over 51%, a condition termed as post-transplant erythrocytosis (PTE). The pathogenesis of PTE is yet to be fully understood. A quarter of them remits spontaneously within 2 years while in others it persists for many years. Male sex, retention of native kidneys, transplant renal artery stenosis and a normal graft function are some of the predisposing factors for the development of PTE. Thromboembolic events occur in about 10-30% of those with PTE. The mortality rate is very less. Use of ACE inhibitors is a safe and well-tolerated treatment for PTE. Therapeutic phlebotomy is usually done when the hematocrit crosses 55% and is very effective. At NU hospitals, we had an unusually high incidence of PTE (26%). Fortunately, none were symptomatic.