Long-term cardiorespiratory effects of amelioration of renal anaemia by erythropoietin.
The long-term cardiorespiratory effects of recombinant human erythropoietin treatment were investigated in ten haemodialysis patients by means of maximum exercise testing, lung function tests, echocardiography, chest X-ray, and rheological assessment over 12 months. There were significant rises in exercise time (mean [SD] 13.2 [5.5] to 20.0 [6.2] min), maximum oxygen consumption (19.1 [7.0] to 25.0 [6.7] ml.min-1.kg-1), and anaerobic threshold (11.7 [3.6] to 15.4 [4.8] ml.min-1.kg-1) after 2 months of erythropoietin treatment. The improvements were maintained but not augmented on repeat testing after 4, 8, and 12 months of therapy. Carbon monoxide transfer [corrected] rose from 15.5 (2.9) to 18.6 (3.7) ml.min-1.mm Hg-1. There was a substantial reduction in exercise-induced cardiac ischaemia (eight patients had significant ST segment depression before erythropoietin, only one after 2 months' treatment, and none after 12 months' treatment), despite a significant rise in whole blood viscosity. Left ventricular mass, as estimated by echocardiography, progressively decreased from 354 (169) g to 251 (95) g after 12 months' treatment, and four patients showed a reduction in cardiothoracic ratio on chest X-ray.
Macdougall
I C
IC
Institute of Nephrology, Cardiff Royal Infirmary, UK.
Lewis
N P
NP
Saunders
M J
MJ
Cochlin
D L
DL
Davies
M E
ME
Hutton
R D
RD
Fox
K A
KA
Coles
G A
GA
Williams
J D
JD
D000328:Adult; D000368:Aged; D000740:Anemia / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D001784:Blood Gas Analysis; D006332:Cardiomegaly / Q000097:blood / Q000188:drug therapy*; D003327:Coronary Disease / Q000097:blood / Q000188:drug therapy*; D004334:Drug Administration Schedule; D004341:Drug Evaluation; D004921:Erythropoietin / Q000008:administration & dosage / Q000627:therapeutic use*; D005080:Exercise Test / Q000187:drug effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications*; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption / Q000187:drug effects*; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000627:therapeutic use; D006435:Renal Dialysis; D012129:Respiratory Function Tests
D011994:Recombinant Proteins; D004921:Erythropoietin