Effect of recombinant human erythropoietin treatment on left ventricular hypertrophy and cardiac function in dialysis patients

Abstract

Background Cardiovascular disease is a significant complication in chronic kidney disease and a major cause of death in dialysis patients. Anemia is associated with reduced survival in patients with renal disease, and anemia is independently associated with an increased risk of cardiovascular disease. The body adapts to anemia by increasing cardiac output, which may result in cardiac remodeling and progression of left ventricular (LV) growth.Aim The aim of this study was to shed light on the effects of correction of anemia after therapy with recombinant human erythropoietin (rHuEPO) on left ventricular hypertrophy (LVH) and consequently LV function in dialysis patients. So we studied 40 hemodialysis patients with hemoglobin (Hb) less than 10 g/dl as well as 10 age-matched and sex-matched hemodialysis patients with Hb more than 11 g/dl who never received erythropoietin as a control group.Patients and methods All participants of the study were subjected to full medical history, thorough medical examination, and investigations including complete blood count, serum ferritin, and echocardiography.Results A significant increase in Hb, packed cell volume (PCV%), and red blood cells (RBCs) count was seen at all months of the study period, with mean Hb at the start of the study being 7.96±0.72 g/dl and at the end of treatment being 10.67±0.83 g/dl. There is a significant increase in ejection fraction (EF%) with significant reduction in left ventricular mass index (LVMI) after treatment in comparison with pretreatment, which means improvement of cardiac function and reduction of LVH after treatment with rHuEPO.Conclusion This prospective study showed that correction of anemia with rHuEPO in the patients undergoing hemodialysis with Hb level less than 10 g/dl led to correction of LVH, with improvement of the cardiac function.