Improvement in exercise capacity after correction of anemia in patients with end-stage renal failure.
Changes in exercise tolerance occurring after correction of anemia with recombinant human erythropoietin in a group of patients with end-stage renal failure were evaluated. Ten patients, aged 29 +/- 11 years, on chronic hemodialysis treatment, with no associated diseases, were evaluated by cardiopulmonary bicycle exercise testing and M-mode, 2-dimensional and pulsed doppler echocardiography before and after anemia correction. After 1 and 3 months of therapy, hemoglobin plasma levels increased from 5.9 +/- 1.2 to 7.7 +/- 1.3 and 9.9 +/- 1.4 g/dl, with a concomitant increase in peak oxygen consumption (VO2) from 21.4 +/- 4.3 to 24.4 +/- 4.3 and 26.6 +/- 4.6 ml/kg/min and of VO2 at the ventilatory threshold from 15.0 +/- 3.7 to 17.3 +/- 3.7 and 16.8 +/- 3.4 ml/kg/min. After 3 months of therapy, systolic blood pressure significantly decreased both at peak exercise (159 +/- 35 to 134 +/- 22 mm Hg) and ventilatory threshold (140 +/- 27 to 123 +/- 19 mm Hg), whereas cardiac index at rest decreased from 3.3 +/- 0.7 to 2.8 +/- 0.5 liters/min/m2 and heart rate from 77 +/- 12 to 70 +/- 10 beats/min. However, no significant relation was found between hemoglobin plasma levels and peak VO2, whereas a significant relation was found between hemoglobin concentration and cardiac index at rest.
Metra
M
M
Cattedra di Cardiologia, Università di Brescia, Italy.
Cannella
G
G
La Canna
G
G
Guaini
T
T
Sandrini
M
M
Gaggiotti
M
M
Movilli
E
E
Dei Cas
L
L
D000328:Adult; D000740:Anemia / Q000097:blood / Q000209:etiology / Q000628:therapy*; D004452:Echocardiography; D004921:Erythropoietin / Q000627:therapeutic use; D005260:Female; D006400:Hematocrit; D006439:Hemodynamics; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D005082:Physical Exertion; D011994:Recombinant Proteins; D006435:Renal Dialysis / Q000009:adverse effects; D012129:Respiratory Function Tests
D006454:Hemoglobins; D011994:Recombinant Proteins; D004921:Erythropoietin