title: Hemodynamic mechanism of the elevation in blood pressure following the improvement of anemia with recombinant human erythropoietin.
abstract: Following the administration of recombinant human erythropoietin (rHuEPO) to 18 patients undergoing hemodialysis, the hematocrit (Ht) increased from 19.7 +/- 1.8 to 31.0 +/- 2.0%. The incidence of hypertension according to the criteria of WHO was 11.1%. The systolic blood pressure (SBP) increased significantly from 120 +/- 21 to 129 +/- 26 mmHg (p less than 0.01) and diastolic blood pressure (DBP) increased from 67 +/- 14 to 73 +/- 12 mmHg (p less than 0.05). The cardiac index (CI) decreased significantly from 4.07 +/- 1.13 to 3.56 +/- 0.88 L/min/m2 (p less than 0.05). Total peripheral resistance index (TPRI) and blood volume (BV) increased significantly from 1,725 +/- 406 to 2,170 +/- 643 dynes/sec/cm-5/m2 (p less than 0.001) and from 78.9 +/- 11.2 to 87.8 +/- 14.8 ml/kg (p less than 0.005) respectively. Pulse rate (PR) decreased significantly from 73.0 +/- 10.7 to 65.9 +/- 7.8 beats/min (p less than 0.01). Patients who developed a blood pressure (BP) elevation of 10% or more for the mean blood pressure (MBP) showed a slight and insignificant decrease in CI from 3.65 +/- 1.12 to 3.49 +/- 1.06 L/min/m2, which clearly contrasted to that in another group of patients who showed a reduced increase in MBP and a significant reduction in CI from 4.50 +/- 1.03 to 3.63 +/- 0.72 L/min/m2 (p less than 0.05). Stroke volume index (SVI) was unchanged in both groups but PR decrease significantly in the latter group. A significant increase in TPRI or BV was observed equally in both groups.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Department of Internal Medicine, Kitasato University School of Medicine, Kanagawa, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Kamata
authors.forename: F
authors.initials: F
authors.lastname: Marumo
authors.forename: K
authors.initials: K
authors.lastname: Onoyama
mesh_terms: D000328:Adult; D000368:Aged; D000740:Anemia / Q000503:physiopathology / Q000628:therapy*; D001810:Blood Volume; D002302:Cardiac Output; D004452:Echocardiography; D004921:Erythropoietin / Q000009:adverse effects*; D005260:Female; D006339:Heart Rate; D006439:Hemodynamics; D006801:Humans; D006973:Hypertension / Q000139:chemically induced* / Q000503:physiopathology; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins / Q000009:adverse effects; D006435:Renal Dialysis; D014655:Vascular Resistance
chemical_list: D011994:Recombinant Proteins; D004921:Erythropoietin