Phlebotomy for erythropoietin-induced malignant hypertension.
Four patients on regular dialysis treatment whose blood pressure was well controlled, developed malignant hypertension while receiving maintenance recombinant human erythropoietin (r-Hu-EPO). None of these patients had a haematocrit greater than 35% at any stage, and clinically, none had any evidence of fluid overload. Initially, they were all managed by stopping r-Hu-EPO and intensification of antihypertensive therapy. However, none of the patients responded, and venesection of 500 ml of blood was performed in each case with swift and sustained response.
Fahal
I H
IH
Regional Renal Unit, Royal Liverpool University, UK.
Yaqoob
M
M
Ahmad
R
R
D000328:Adult; D000740:Anemia / Q000188:drug therapy / Q000209:etiology; D001794:Blood Pressure; D001810:Blood Volume; D001815:Bloodletting; D004921:Erythropoietin / Q000009:adverse effects*; D005260:Female; D006801:Humans; D006974:Hypertension, Malignant / Q000139:chemically induced / Q000503:physiopathology / Q000628:therapy*; D007676:Kidney Failure, Chronic / Q000150:complications; D008875:Middle Aged
D004921:Erythropoietin