title: Influence of erythropoietin on arterial stiffness and endothelial function in renal transplant recipients.
abstract: OBJECTIVE
  Recent retrospective studies suggest an association of therapy with erythropoiesis-stimulating agents (ESAs) and increased mortality in renal transplant recipients (RTR). Large artery structure and function are significantly impaired in RTR which contributes to their high cardiovascular morbidity and could be altered by erythropoietin. We aimed to examine the influence of ESA therapy on large artery stiffness and endothelial function in RTR.
  
  
  METHODS
  63 RTR with chronic allograft dysfunction and renal anemia were randomized to a group receiving darbepoetin alfa (Dar) and a control group (Co). At baseline and after 8 months of treatment (cumulative Dar dose 11.1 µg/kg b.w.) brachial and common carotid artery distensibility coefficients, aortic pulse wave velocity, brachial artery flow-mediated and nitroglycerin-mediated vasodilation were measured as well as the following biomarkers of vascular function: vWF, sVCAM, sICAM, E-selectin, t-PA and PAI-1.
  
  
  RESULTS
  23 patients in the Dar group and 17 patients in the Co group were available for per-protocol analysis. Hemoglobin increased significantly from 10.9 to 12.6 g/dl after 8 months in the Dar group, whereas it remained stable at 11.3 g/dl in the Co group. Effects on large artery stiffness, endothelial function and biomarkers of vascular function did not differ significantly between the two groups.
  
  
  CONCLUSIONS
  Therapy with Dar during 8 months did not significantly impact parameters of large artery stiffness and endothelial function in RTR. These data suggest that therapy with erythropoietin does not deteriorate arterial stiffness and endothelial function in RTR.
authors.affiliation: Department II of Internal Medicine, University of Cologne, DE–50937 Cologne, Germany. valerie.bartels@uk-koeln.de
authors.forename: Valerie
authors.initials: V
authors.lastname: Bartels
authors.forename: Uta
authors.initials: U
authors.lastname: Hillebrand
authors.forename: Markus
authors.initials: M
authors.lastname: Kosch
authors.forename: Martin
authors.initials: M
authors.lastname: Hausberg
authors.forename: Klaus
authors.initials: K
authors.lastname: Kisters
authors.forename: Giovana Seno
authors.initials: GS
authors.lastname: Di Marco
authors.forename: Stefanie
authors.initials: S
authors.lastname: Reiermann
authors.forename: Hermann
authors.initials: H
authors.lastname: Pavenstaedt
authors.forename: Detlef
authors.initials: D
authors.lastname: Lang
mesh_terms: D000740:Anemia / Q000188:drug therapy / Q000401:mortality; D001916:Brachial Artery / Q000502:physiology; D000068256:Darbepoetin alfa; D004730:Endothelium, Vascular / Q000187:drug effects*; D004921:Erythropoietin / Q000008:administration & dosage / Q000031:analogs & derivatives*; D005260:Female; D006397:Hematinics / Q000008:administration & dosage; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D055031:Primary Graft Dysfunction / Q000188:drug therapy* / Q000401:mortality; D012307:Risk Factors; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D059289:Vascular Stiffness / Q000187:drug effects*; D014664:Vasodilation / Q000187:drug effects / Q000502:physiology
chemical_list: D006397:Hematinics; D004921:Erythropoietin; D000068256:Darbepoetin alfa