IMPROVEMENT OF ERYTHROPOIETIN-INDUCED HYPERTENSION IN HEMODIALYSIS-PATIENTS CHANGING THE ADMINISTRATION ROUTE

The aim of the present study has been to assess whether the administra tion of recombinant human erythropoietin (rHuEPO) by the subcutaneous (sc) route improves blood pressure control of dialysis patients with e rythropoietin-induced hypertension. We have selected 13 hemodialysis p atients who remained hypertensive after more than one year of iv rHuEP O treatment (mean 22 +/- 8 months, range 12-35 months). Hematocrit, rH uEPO dose, predialysis mean arterial pressure and antihypertensive dru g dosage had remained constant during the last six months. These patie nts were switched to sc administration of rHuEPO thrice weekly, with r eduction of rHuEPO dose by one third (from 149 +/- 56 to 98 +/- 53 IU/ kg/week). Concomitantly, predialysis mean arterial pressure significan tly decreased (113.1 +/- 7.8 during the last month of iv administratio n vs 107.8 +/- 9.8 during the first month of sc administration, p < 0. 05, and 105.5 +/- 5.2 mmHg at six months, p < 0.05), without relevant changes in hematocrit. After six months of sc administration, 5 patien ts remained normotensive without drugs and 6 out of the remaining 8 pa tients required antihypertensive drugs at lower doses. Administration of rHuEPO by sc route decreases dose requirements and improves blood p ressure control in hypertensive patients when treated by iv route.