Cardiovascular function in a chronic peritoneal dialysis pediatric population on recombinant human erythropoietin treatment.
Anemia, through a hyperkinetic state, is an important contributor to myocardial function impairment. To determine the cardiovascular effects of recombinant human erythropoietin (rHuEPO) therapy, 10 chronic peritoneal dialysis (CPD)-treated anemic children were studied before and during 18 months of treatment. The following parameters were recorded: hemoglobin (Hb) [percent of target level (TL) = x-2 standard deviations of normal Hb values for age and sex], heart rate (HR, beats/minute), mean arterial pressure (MAP, mmHg), end-diastolic left ventricular diameter (EDLVD, mm/sm BSA), shortening fraction (SF, percent), and interventricular septal thickness (IVS, mm/sm BSA). Student's t-test for paired data showed (vs time before treatment, T0) a progressive increase in Hb, a progressive decrease in HR, and a progressive increase in MAP. EDLVD progressively decreased, while SF and IVS remained unchanged throughout the study. Regression analysis showed a close correlation between anemia correction and decrease of HR (p < 0.01), while no correlation was found between Hb and EDLVD or SF, IVS, or MAP. Our data indicate that anemia correction in these patients is mainly associated with a decrease in hyperkinetic state (HR reduction with SF unvaried), while left ventricular function and dimensions remain normal, despite an increase in MAP.
Department of Nephrology, Children's Hospital, Brescia, Italy.
S
S
Bassi
G
G
Montini
A
A
Edefonti
F
F
Perfumo
D
D
Cattarelli
G
G
Piaggio
V
V
Fesslova
G
G
Zacchello
S
S
Bove
D000740:Anemia / Q000097:blood / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D001794:Blood Pressure; D002648:Child; D004921:Erythropoietin / Q000627:therapeutic use*; D005260:Female; D006321:Heart / Q000503:physiopathology*; D006339:Heart Rate; D006439:Hemodynamics; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications; D008297:Male; D009200:Myocardial Contraction; D010530:Peritoneal Dialysis; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000627:therapeutic use; D016277:Ventricular Function, Left
D006454:Hemoglobins; D011994:Recombinant Proteins; D004921:Erythropoietin