The effect of recombinant human erythropoietin (r-HuEPO) on left ventricular mass and left ventricular hemodynamics in hemodialysis patients.

Abstract

The purpose of this study was to examine the effect of recombinant human erythropoietin (r-HuEPO) on left ventricular mass. Twenty-seven hemodialysis patients (13 men and 14 women) were given r-HuEPO for renal anemia. Blood pressure and heart rate were measured before and after the 16-week course of r-HuEPO, and at the same time echocardiography was performed to measure left ventricular dimensions and wall thickness. These measurements were used to calculate left ventricular volume, cardiac output (CO), and left ventricular mass (LVmass). Diastolic blood pressure (DBP) increased after administration of r-HuEPO (from 75.8 +/- 10.8 mmHg to 85.6 +/- 12.7 mmHg), but there was no change in systolic blood pressure (SBP) or heart rate. LVmass increased significantly in seven cases (from 194.7 +/- 40.0 g to 240.3 +/- 47.3 g). These cases, Group I, showed no decline in stroke volume (SV) or CO, and showed significant increases in SBP. In the remaining 20 cases, Group II, LVmass decreased or was unchanged. In this group SV and CO decreased, but there was no increase in SBP. We conclude that increases in LVmass may be associated with elevated systolic blood pressure and hypertrophy of the left ventricular wall, when hemodialysis patients with severe renal anemia are given r-HuEPO.