Hypertension as a possible complication of recombinant human erythropoietin therapy.
The analysis of the hemodynamics accompanying correction of renal anemia by rhEPO shows that--although they behave qualitatively as in nonuremic anemic patients--cardiac output and peripheral resistance may change inadequately and thereby cause a rise of blood pressure. The underlying mechanisms are not yet fully understood but to a great part may be related to preexisting pathology due to a history of longlasting hypertension. In some patients the development of hypertension may only represent a temporary phenomenon of hemodynamic dysregulation. To avoid cardiovascular complications the following should be considered: Patients with a history of hypertension, even if they are normotensive in the anemic state, are at a higher risk of developing hypertension during therapy with rhEPO. Hypertensive complications may be rare events when anemia is corrected slowly. In case of the development or aggravation of hypertension a reduction of the target hematocrit is indicated.
Brunkhorst
R
R
Abteilung Nephrologie, Medizinische Hochschule Hannover, FRG.
Nonnast-Daniel
B
B
Koch
K M
KM
Frei
U
U
D000740:Anemia / Q000188:drug therapy*; D002302:Cardiac Output / Q000187:drug effects; D004921:Erythropoietin / Q000009:adverse effects*; D006801:Humans; D006973:Hypertension / Q000209:etiology*; D007676:Kidney Failure, Chronic / Q000150:complications*; D011994:Recombinant Proteins / Q000009:adverse effects; D014655:Vascular Resistance / Q000187:drug effects
D011994:Recombinant Proteins; D004921:Erythropoietin