Pressor effect of recombinant human erythropoietin: results of home blood pressure measurements in hemodialysis patients.
We investigated whether the treatment of anemic hemodialysis patients with a low dose of recombinant human erythropoietin (rHEpo) for a short period would increase the blood pressure (BP). Home BP measurements were used to detect minute increases in BP. Fifty-one anemic patients on maintenance hemodialysis with a hematocrit of 25% or less received rHEpo at the dose of 4500 IU/week by the intravenous route for 8 weeks. Overall, rHEpo did not increase the BP whether measured at home or in the clinic (causal BP). Hemoglobin concentration increased significantly from 7.1 +/- 0.7 to 8.8 +/- 0.7 g/dl. Patients were classified into two groups according to the change in mean (M) home BP induced by rHEpo: a pressor group (delta MBP > or = 5 mmHg, n = 17) and a non-pressor group (delta MBP < 5 mmHg, n = 34). The hemoglobin concentration rose significantly in both groups, but there was no change in casual BP. Home blood pressure measurements showed a gradual and continuous rise in BP in the pressor group, but not in the non-pressor group. Patients administered antihypertensive medications before rHEpo treatment accounted for 88% of the former and 50% of the latter groups. Two patients with malignant nephrosclerosis were included in the pressor group. The findings indicate that rHEpo, even given at a low dose for a short period, elevates the BP, as determined by home BP measurement, but not by casual measurements obtained in the clinic.
Imai
Y
Y
Second Department of Medicine, Tohoku University School of Medicine, Sendai, Japan.
Fujikura
Y
Y
Minami
N
N
Munakata
M
M
Hashimoto
J
J
Sakuma
H
H
Watanabe
N
N
Nishiyama
A
A
Misawa
S
S
Sekino
H
H
D000328:Adult; D000368:Aged; D000740:Anemia / Q000628:therapy*; D001795:Blood Pressure Determination / Q000379:methods; D004921:Erythropoietin / Q000009:adverse effects*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins / Q000009:adverse effects; D006435:Renal Dialysis
D011994:Recombinant Proteins; D004921:Erythropoietin