Effect of Erythropoietin Administration on Blood and Plasma Viscosity in Hemodialysis Patients

Vaziri, Nosratola D.; Ritchie, C D; Brown, Patricia; Kaupke, Jeffrey; Atkins, Katey; Barker, Steven J.; Hyatt, John A.

doi:10.1097/00002480-198907000-00107

Cited by 13 publications

(7 citation statements)

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“…The rHuEPO-induced rise in blood viscosity measured in this prospective, randomized, placebo-controlled study was similar to that reported in other studies on dialysis patients [1][2][3][4][5][6][7], The rise in blood viscosity was not associated with any adverse change in fistula hemodynamics. In con trast to the findings of other uncontrolled studies [6][7][8][9][10], no patient in our study developed fistula thrombosis during 12 weeks of observation.…”

Section: Discussionsupporting

confidence: 87%

“…A consequence of treating anemia with recombinant human erythropoietin (rHuEPO) is a rise in whole blood viscosity [1][2][3][4][5]. Changes in the rheological properties of blood have been implicated in contributing to the two main adverse side effects reported following rHuEPO treatment in dialysis patients with renal anemia, namely an elevation of blood pressure and thrombosis at the site of vascular access [6][7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

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Hemorheology and Fistula Function in Home Hemodialysis Patients following Erythropoietin Treatment: A Prospective Placebo-Controlled Study

Al²,

Ma³

et al. 1993

Nephron

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The beneficial effect of correcting anemia in end stage renal failure using recombinant human erythropoietin (rHuEPO) is sometimes complicated by thrombosis of the arteriovenous fistula. This placebo-controlled study investigated the relationship between hemorheological changes caused by rHuEPO and alterations in fistula function and heparin requirements in home hemodialyis patients. Erythropoietin induced a rise in high shear rate blood viscosity, a determinant of blood flow in large vessels. Doppler assessment of brachial artery blood flows, tests of fistula function and heparin requirements were similar in the two patient groups. These findings indicate that rHuEPO treatment of renal anemia resulted in the expected rise in red blood cell mass and blood viscosity although these changes did not cause problems with arteriovenous access or alter fistula function in the short term.

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Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Hemorheology and Fistula Function in Home Hemodialysis Patients following Erythropoietin Treatment: A Prospective Placebo-Controlled Study

Al²,

Ma³

et al. 1993

Nephron

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“…r-HuEPO increases the haematocrit which results in an increased blood viscosity [8]. Plasma viscosity is not changed by r-HuEPO treatment [10]. Moreover, the platelet count increases significantly during the initial phase of r-HuEPO treatment, but thrombocytosis rarely develops [7].…”

Section: Discussionmentioning

confidence: 99%

Renal transplantation in r-HuEPO-treated patients

Seeberger

Tibell

Tydén

1992

Transplant International

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After sporadic reports of renal graft artery thromboses, prophylaxis against thrombosis (PAT) was given to all of our r-HuEPO-treated patients (n = 35) during a period of 2 years. No thromboembolic events (TEE) occurred in the r-HuEPO-treated group receiving PAT. However, the PAT-protocol (500 ml dextran on days 0, 1, 3 and 5, followed by low doses of aspirin, 160-250 mg daily) resulted in a 54.3% incidence of bleeding complications, of which 22.9% were major (i.e., necessitating multiple transfusions or invasive procedures). A group of renal graft recipients (n = 83), who were not treated with r-HuEPO and were not given PAT, showed a 10.8% incidence of bleeding complications of which 2.4% major. Two cases of TEE were noted in the untreated group. The difference in bleeding complications between the two groups was statistically significant (0.025 > P > 0.01 ). The

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“…Various factors that have been proposed to have a causal role in erythropoietininduced hypertension include direct vasoconstrictive effect of erythropoietin, diminished response to nitric oxide, increase in plasma endothelin levels, arterial remodeling, high dose of erythropoietin, rapid increase in hematocrit, increased responsiveness to norepinephrine, increase in intracytosolic calcium levels, prior personal or family history of hypertension. 51,52,[55][56][57][58][59][60][61][62][63][64] Rapid reversal of anemia-induced peripheral vasodilatation with reversal of anemia induced increase in cardiac output lagging behind, contributes hemodynamically to rise in blood pressure seen with erythropoietin. When erythropoietin causes a rapid increase in blood pressure, it may cause hypertensive encephalopathy and seizures.…”

Section: Treatmentmentioning

confidence: 99%