HEMODYNAMIC-CHANGES AND EXERCISE TOLERANCE IN DIALYSIS PATIENTS TREATED WITH ERYTHROPOIETIN

The aim of our study was to evaluate cardiovascular function at rest a nd during exercise in dialysis patients before and after treatment wit h Epo and to examine the changes in left ventricular mass as the conse quence of treatment for anaemia. We applied echocardiography and radio nuclide ventriculography at rest and after exercise in our research. F ollowing treatment with Epo there was a decrease in the initially high cardiac output (GO) and cardiac index (CI) from 7.5 to 6.3 l/min and from 4.3 to 3.6 l/min/m(2) respectively. No changes were noted in mean diastolic (DPB) and mean blood pressure (MBP), as well as the initial ly increased peripheral resistance index (TPRi) of 2582.3+/-2097.3 dyn -s-cm(-5). m(2). Nevertheless, end-diastolic(EDV) and endsystolic (ESV ) volume were significantly decreased (P<0.05), but the ejection fract ion (EF) remained unchanged (73.9%). The decrease in the mean values f or left ventricular mass (LVM) was significant only within the subgrou p of dialysed patients who initially had larger left ventricular mass (P<0.01). The functional capacity of the CV system measured during exe rcise increased from four metabolic equivalents (METs) to 6 METs (P<0. 01). A significant increase in blood volume was also observed followin g treatment of anaemia. The haemodynamic consequences of Epo therapy f or the treatment of anaemia were quite positive. However, we would lik e to point out certain concerns regarding the dialysed patients with i nitially lower values for left ventricular mass and cardiac output, si nce the patients within this group developed left ventricular hypertro phy and an increase in cardiac output.