RENAL ANEMIA TREATMENT WITH RECOMBINANT-HUMAN-ERYTHROPOIETIN INCREASES CARDIAC-OUTPUT IN PATIENTS WITH ISCHEMIC-HEART-DISEASE

An increase in blood pressure is common during treatment of renal anae mia with recombinant human erythropoietin (rhEPO). Concomitant finding s of a decrease in cardiac output indicate that an increase in the per ipheral flow resistance underlies the increase in blood pressure. The aim of this study was to elucidate the haemodynamic changes during rhE PO treatment in patients with ischaemic heart disease (IHD). Haemodyna mic variables were assessed by impedance cardiography in 18 consecutiv e patients with renal anaemia before and after rhEPO treatment. ii-ID was found in eleven of these patients. The remaining seven served as c ontrols. Before rhEPO treatment, the cardiac index was decreased in th e group of patients with IHD, compared with controls and healthy subje cts. Due to an increase in stroke index, the cardiac index increased d uring rhEPO treatment and reached values equal to those in the control group. The blood pressure increased and the increase in mean arterial pressure was correlated to the increase in cardiac index. Apparently the patients with IHD were unable to compensate for anaemia by increas ing their cardiac index. Anaemia treatment increased cardiac index, wh ich in turn caused an increase in blood pressure in these patients.