Morphologic and functional changes of left ventricle in dialyzed patients after treatment with recombinant human erythropoietin (r-HuEPO)

Dysfunction of the cardiovascular system is a common complication of chroni c renal insufficiency. Many factors can cause left ventricular hypertrophy (LVH), and hypertension and anemia are among them. They play an important r ole in the pathogenesis of LVH as well as in the development of cardiac dys function. Echocardiography enables early detection of functional macrocircu latory changes as well as adequate measuring of cardiac structures and LV m ass. Anemia of end-stage chronic renal insufficiency (ESRD) is only one amo ng its many complications and has complex pathogenesis; one of the primary factors causing anemia is insufficient production of erythropoietin, a lead ing factor in the production of erythropoiesis. Anemia correction with reco mbinant human erythropoietin (r-HuEPO) in ESRD has a positive effect on the cardiovascular system. In this study the authors examined the hemodynamic effect of erythropoietin in anemic patients undergoing hemodialysis and obs erved its positive effect on the cardiovascular system. Twenty-two patients were included in the study (13 men and 9 women) mean age x=39.5 years. All patients were dialyzed three times a week for 4 hours and were all treated , according to protocol, with r-HuEPO for 8 months. Left ventricular mass w as measured by the Perm Convention formula. The authors noticed the effecti veness of this therapy through an increase of hemoglobin of 35% and of hema tocrit of 34% and a direct effect on the cardiovascular system. Echocardiog raphic findings showed decrease of LV mass from 391 to 274 mg (30%). The correction of renal anemia with erythropoietin leads to structural micr ocirculatory changes and partial morphologic regression of preexistent LVH, which again leads to regression of cardiac dysfunctions and improved hemod ynamic effect, physical capacity, and cardiopulmonary status, and ultimatel y better quality of life for dialyzed patients.