title: Changes in the alpha adrenergic system and increase in blood pressure with recombinant human erythropoietin (rHuEpo) therapy for renal anemia.
abstract: Recombinant human erythropoietin (rHuEpo) is effective in correcting renal anemia with the development of hypertension as the most frequent side-effect. Compared to hemodialysis patients with normal hemoglobin concentration, nine examined patients with transfusion-dependent renal anemia had low blood pressure in the context of high alpha 2-receptor densities and high plasma levels of catecholamines. This constellation can be explained by a defective receptor-ligand-interaction. During treatment with rHuEpo all patients showed an increase in blood pressure due to increased peripheral resistance, accompanied by a significant fall in plasma noradrenaline and alpha 2-receptor-density. There was a significant negative correlation between hemoglobin concentration and alpha 2-receptor density. We conclude that correction of renal anemia abolishes anemia-mediated disturbance of alpha 2-receptor function with the consequence of receptor down-regulation and increased vasoconstriction, which contributes to the rise in arterial blood pressure.
authors.affiliation: Medical Clinic II, University of Cologne, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Müller
authors.forename: H M
authors.initials: HM
authors.lastname: Steffen
authors.forename: R
authors.initials: R
authors.lastname: Brunner
authors.forename: J
authors.initials: J
authors.lastname: Saric
authors.forename: M
authors.initials: M
authors.lastname: Pollok
authors.forename: C A
authors.initials: CA
authors.lastname: Baldamus
authors.forename: W
authors.initials: W
authors.lastname: Kaufmann
mesh_terms: D000328:Adult; D000368:Aged; D000740:Anemia / Q000188:drug therapy* / Q000209:etiology; D001809:Blood Viscosity; D004837:Epinephrine / Q000097:blood; D004921:Erythropoietin / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006439:Hemodynamics; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D006973:Hypertension / Q000139:chemically induced*; D007676:Kidney Failure, Chronic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009638:Norepinephrine / Q000097:blood; D011942:Receptors, Adrenergic, alpha / Q000502:physiology*; D011994:Recombinant Proteins / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D006454:Hemoglobins; D011942:Receptors, Adrenergic, alpha; D011994:Recombinant Proteins; D004921:Erythropoietin; D009638:Norepinephrine; D004837:Epinephrine