Effect of recombinant human erythropoietin on adrenergic activity in normotensive hemodialysis patients

Ten normotensive hemodialysis patients with severe anemia participated in t he study. Human recombinant erythropoietin (rHuEpo) was administered i.v. 3 times a week in doses of 50 U/kg of body, weight. During 12 weeks of obser vation, the mean hematocrit value increased from 19%, before start of thera py, to 32%. Simultaneous monitoring of serum plasma noradrenaline (NA) conc entration showed an elevation from 202 to 281 pg/ml. An increase of NA conc entration after a cold pressure stimulating test (CP) was not statistically significant after as compared to before treatment, but became statisticall y significant after 12 weeks of rHuEpo therapy (281 pg/ml before to 441 pg/ ml after CP test, p < 0.01). The mean arterial blood pressure increased fro m 92 - 109 mmHg after 12 weeks of rHuEpo therapy (p < 0.001). We have demon strated significantly increased NA blood concentrations after 12 weeks of r HuEPO therapy in normotensive patients, which correlated with increased MAP . This may suggest that the observed increase of noradrenaline concentratio n as a vasoactive substance after the CP test may contribute to hypertensio n during rHuEPO therapy.