EFFECTS OF RECOMBINANT-HUMAN-ERYTHROPOIETIN ON ECHOCARDIOGRAPHIC FINDINGS IN ELDERLY DIALYSIS PATIENTS

Twenty anaemic, normotensive and elderly patients on both haemodialysi s and CAPD with left ventricular hypertrophy (LVH) were undergoing sys tematic echocardiographic analysis during treatment with recombinant h uman erythropoietin (rHuEPO) for 12 months. Before and after the rHuEP O treatment, M-mode and pulsed Doppler echocardiographic were performe d and haemodynamic parameters were closely followed. Partial correctio n of anaemia resulted in a decrease in the LV end-diastolic diameter ( LVEDD) from 56.0 +/- 2.0-49.2 +/- 2.0 mm (P<0.05) in HD patients and 5 0.5 +/- 4.0-43.6 +/- 3.0 mm in CAPD patients (P = NS). Concomitantly t he calculated mass index (LVMi) was reduced significantly from 232.3 /- 21.8-185.9 +/- 11.4 g/m(2) in elderly haemodialysis patients. Heart rate and arterial pressure did not change during the study period. Ho wever, in CAPD patients there was no significant change in LVMi during the study period. We conclude that long-term amelioration of anaemia in dialysis patients could induce a regression of left ventricular hyp ertrophy. However, in CAPD patients, both myocardial and haemodynamic effects were less evident. CAPD could possibly modulate the haemodynam ic changes associated with the rHuEPO treatment or CAPD itself impose less left ventricular wall stress in these elderly patients.