title: Does increasing haemoglobin concentration and haematocrit have a pressor effect in dialysis patients?
abstract: The haemodynamic consequences of differing rates of rise of haemoglobin and haematocrit in haemodialysis and CAPD patients were examined. Pre-dialysis mean arterial pressure, weight and haematological indices were recorded in 100 established haemodialysis patients prior to a 2-unit blood transfusion and repeated, pre-dialysis, within 1 week. Haemoglobin rose from 6.7 +/- 0.2 to 9.3 +/- 0.1 g/dl, weight was unchanged, and there was a small fall in mean arterial pressure. Similar indices were recorded, including the mid-arm circumference (MAC) in 100 CAPD patients 1 month after starting CAPD and at the time of maximum haemoglobin within the first year. Haemoglobin rose from 8.5 +/- 0.1 to 10.7 +/- 0.1 g/dl, weight increased slightly, but there was no change in MAC: weight ratio and there was a small fall in mean arterial pressure. In neither group was there a change in antihypertensive medication. In conclusion, increasing the haemoglobin concentration and haematocrit of dialysis patients within the range described in this study did not promote elevated blood pressure.
authors.affiliation: Leicester General Hospital, UK.
authors.forename: B
authors.initials: B
authors.lastname: Williams
authors.forename: M E
authors.initials: ME
authors.lastname: Edmunds
authors.forename: J P
authors.initials: JP
authors.lastname: Thompson
authors.forename: P R
authors.initials: PR
authors.lastname: Burton
authors.forename: J
authors.initials: J
authors.lastname: Feehally
authors.forename: J
authors.initials: J
authors.lastname: Walls
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology*; D001803:Blood Transfusion; D001826:Body Fluids / Q000502:physiology; D001835:Body Weight / Q000502:physiology; D005260:Female; D006400:Hematocrit; D006454:Hemoglobins / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory; D006435:Renal Dialysis / Q000009:adverse effects*; D012189:Retrospective Studies
chemical_list: D000959:Antihypertensive Agents; D006454:Hemoglobins