Effect of erythropoietin therapy on red cells filterability and left ventricular mass in predialysis patients.
BACKGROUND
Cardiovascular complications are the leading cause of mortality in patients with end-stage renal disease. Left ventricular hypertrophy (LVH) is recognized as an independent risk factor for cardiovascular morbidity and mortality. At the onset of dialysis, more than 70% of the patients with chronic kidney disease have echocardiographic evidence of LVH. Anemia, increased red cells filterability time (RCFT), and blood viscosity are known to induce LVH.


OBJECTIVE
To evaluate, prospectively, the effects of erythropoietin (EPO) therapy for 20 weeks on RCFT and left ventricular mass (LVM).


METHODS
Twenty uremic and anemic predialysis patients with creatinine clearance test below 35 mL/min were studied. RCFT test and three-dimensional echocardiography were performed at 0, 10, and 20 weeks.


RESULTS
EPO therapy for 20 weeks did not adversely affect renal function and did not significantly change the mean blood pressure. It significantly increased the hemoglobin and fibrinogen levels, and decreased RCFT and LVM (p < .01).


CONCLUSIONS
Although correction of anemia can contribute to regression of LVM, we speculate that an increasing number of cells with normalized viscoelastic properties and a direct effect of EPO on erythrocytes and myocardiocytes, through specific receptors, may also play an important role.
Hassan
Kamal
K
Nephrology and Hypertension Department, Western Galilee Hospital, Nahariya, Israel. drkamalh@hotmail.com
Roguin
Nathan
N
Kaganov
Yan
Y
Hasan
Shadi
S
Kristal
Batya
B
D000368:Aged; D000740:Anemia / Q000188:drug therapy; D019560:Echocardiography, Three-Dimensional; D004907:Erythrocyte Deformability / Q000187:drug effects*; D004921:Erythropoietin / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000517:prevention & control*; D007676:Kidney Failure, Chronic / Q000150:complications / Q000188:drug therapy; D008297:Male; D011446:Prospective Studies; D011994:Recombinant Proteins; D006435:Renal Dialysis
D011994:Recombinant Proteins; D004921:Erythropoietin