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

Bi, Shand; Al, Buttimore; Ma, Hurrell; Je, Wells; Ja, Inkster; Rr, Bailey; Ra, Robson; Kl, Lynn

doi:10.1159/000187278

Cited by 18 publications

(4 citation statements)

References 8 publications

(14 reference statements)

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“…30 However, many studies, including this one, could not confirm this. [31][32][33][34][35] Acetylsalicylic acid [36][37][38] and angiotensinconverting enzyme-inhibitors [39][40][41] have both been indicated as possible inhibitors of IH. In the current study, patients using these drugs did not have less graft failure.…”

Section: Discussionmentioning

confidence: 99%

Effects of a venous cuff at the venous anastomosis of polytetrafluoroethylene grafts for hemodialysis vascular access

Lemson¹,

Tordoir²,

Det³

et al. 2000

Journal of Vascular Surgery

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A venous cuff at the venous anastomosis of PTFE arteriovenous grafts for hemodialysis reduced the incidence of thrombotic occlusions; stenosis at the venous anastomosis was reduced. However, this did not result in a better patency rate. Therefore, the venous cuff should not be used routinely. Initial vein diameter and local problems (edema, obesity, or skin atrophy) appear to be the most important risk factors for graft failure.

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Section: Discussionmentioning

confidence: 99%

Effects of a venous cuff at the venous anastomosis of polytetrafluoroethylene grafts for hemodialysis vascular access

Lemson¹,

Tordoir²,

Det³

et al. 2000

Journal of Vascular Surgery

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“…We also did not notice any complications of erythropoietin, such as increased blood pressure and/or thromboembolic complications. [35][36][37] The therapy for hypertensive patients need not be changed. The correction of renal anemia with erythropoietin leads to structural microcirculatory changes and to partial morphologic regression of the preexisting LV hyper-trophy.…”

Section: Discussionmentioning

confidence: 99%

Morphologic and Functional Changes of Left Ventricle in Dialyzed Patients After Treatment with Recombinant Human Erythropoietin (r-HuEPO)

Jeren-Strujić

Raos²,

Jeren³

et al. 2000

Angiology

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Dysfunction of the cardiovascular system is a common complication of chronic renal insufficiency. Many factors can cause left ventricular hypertrophy (LVH), and hypertension and anemia are among them. They play an important role in the pathogenesis of LVH as well as in the development of cardiac dysfunction. Echocardiography enables early detection of functional macrocirculatory changes as well as adequate measuring of cardiac structures and LV mass. Anemia of end-stage chronic renal insufficiency (ESRD) is only one among its many complications and has complex pathogenesis; one of the primary factors causing anemia is insufficient production of erythropoietin, a leading factor in the production of erythropoiesis. Anemia correction with recombinant 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 observed 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 (Abstract continued) treated, according to protocol, with r-HuEPO for 8 months. Left ventricular mass was measured by the Penn Convention formula. The authors noticed the effectiveness of this therapy through an increase of hemoglobin of 35% and of hematocrit of 34% and a direct effect on the cardiovascular system. Echocardiographic findings showed decrease of LV mass from 391 to 274 mg (30%). The correction of renal anemia with erythropoietin leads to structural microcirculatory changes and partial morphologic regression of preexistent LVH, which again leads to regression of cardiac dysfunctions and improved hemodynamic effect, physical capacity, and cardiopulmonary status, and ultimately better quality of life for dialyzed patients.

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“…However, rhEPO treatment may also have adverse haemodynamic effects that are assumed to be related to rheological alterations of blood (Fisher, 1997;Raine, 1988;Murphy & Parfrey, 1999). For example, increased blood pressure and thrombotic complications have been reported in relation to rhEPO treatment (Bohler et al, 1993;Shand et al, 1993;Zhou et al, 1997). Sudden deaths have also been reported among top-level sportsmen who were illegally using rhEPO for enhanced performance (Gareau et al, 1996).…”

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confidence: 99%

Erythropoietin‐induced rheological changes of rat erythrocytes

et al. 2000

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Summary. The effects of recombinant human erythropoietin (rhEPO) on red blood cell (RBC) rheological properties were investigated in rats. Rats received intramuscular injections of 150 U/kg/d rhEPO for 5 d, following which blood samples were obtained 1, 5 or 10 d later. RBC deformability was assessed by determining cell transit times through 5-mm micropores (CTA) and RBC shape recovery time constants via photometry, aggregation in plasma and dextran was measured by photometry and RBC electrophoretic mobility was determined in a cylindrical electrophoresis system. RBC aggregation was found to be significantly decreased on day 5 after rhEPO treatment (P , 0´05), yet was unchanged from control on days 1 and 10. Mean RBC micropore transit times remained unchanged, but the distributions of transit times were altered; compared with control, the 5th percentiles on both days 1 and 5 were decreased and the 95th percentile on day 1 was elevated. Electrophoretic mobility of RBCs in phosphate-buffered saline was significantly increased on day 5 after rhEPO treatment (P , 0´05), with mobility measurements in dextran 500 (MW 500 kDa) solutions suggesting that the cells' surface properties related to the formation of a`depletion layer' may be altered on day 1. These results indicate that the rheological behaviour of RBC as a consequence of rhEPO treatment are temporal and are affected by the presence of reticulocytes as well as by the average age of the circulating cells.

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

Cited by 18 publications

References 8 publications

Effects of a venous cuff at the venous anastomosis of polytetrafluoroethylene grafts for hemodialysis vascular access

Effects of a venous cuff at the venous anastomosis of polytetrafluoroethylene grafts for hemodialysis vascular access

Morphologic and Functional Changes of Left Ventricle in Dialyzed Patients After Treatment with Recombinant Human Erythropoietin (r-HuEPO)

Erythropoietin‐induced rheological changes of rat erythrocytes

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