Seizures in Dialysis Patients Treated with Recombinant Erythropoietin. Review of the Literature and Guidelines for Prevention

Beccari, M.

doi:10.1177/039139889401700102

Cited by 41 publications

(21 citation statements)

References 44 publications

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“…Hypertension and increased viscosity due to r-HuEpo treatment may cause hypertensive encephalopathy, cerebral convulsion, hypoperfusion, focal cerebral edema and seizures [165] at approximately 5% [166]. One other possible sideeffect of r-HuEpo is the risk for thromboembolic events.…”

Section: Adverse Effects Of Recombinant Erythro-poietinmentioning

confidence: 99%

Erythropoietin in Heart Failure and Other Cardiovascular Diseases: Hematopoietic and Pleiotropic Effects

Manolis¹,

Tzeis²,

Triantafyllou³

et al. 2005

CDTCHD

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Erythropoietin is a hypoxia-induced hormone that is a major regulator of normal erythropoiesis. Over the last decade, the production of recombinant human erythropoietin has revolutionized the treatment of anemia associated with chronic renal failure, and has led to a greater understanding of anemia pathophysiology and to the elucidation of the interactions of erythropoietin, iron, and erythropoiesis. Anemia has been shown to be independently associated with increased mortality and disease progression. Potential survival benefits associated with correction of anemia have expanded considerably the indications of erythropoietin use in various patient populations and are leading to consideration of earlier, more aggressive treatment of mild to moderate anemia. The results of such treatment are promising in a variety of new clinical settings, including anemia associated with congestive heart failure. Furthermore, the erythropoietin receptor is widely distributed in the cardiovascular system, including endothelial cells, smooth muscle cells and cardiomyocytes and preclinical studies have established erythropoietin to be a pleiotropic cytokine with anti-apoptotic activity and tissue-protective actions in the cardiovascular system, beyond correction of hemoglobin levels. Despite some potential adverse effects, such as hypertension, and the occurrence of erythropoietin resistance, early studies in heart failure patients with anemia suggest that erythropoietin therapy is safe and effective in reducing left ventricular hypertrophy, enhancing exercise performance and increasing ejection fraction.Anemia is found in about one-third of all cases of congestive heart failure (CHF). The most likely common cause is chronic renal insufficiency, which is present in about half of all CHF cases. However, anemia can occur in CHF without renal insufficiency and is likely to be due to excessive cytokine production. The anemia itself can worsen cardiac function, both because it causes cardiac stress through tachycardia and increased stroke volume, and because it can cause a reduced renal blood flow and fluid retention, adding further stress to the heart. Long-standing anemia of any cause can cause left ventricular hypertrophy, which can lead to cardiac cell death through apoptosis and worsen CHF. Therefore, a vicious circle, cardio-renal anemia syndrome, is set up wherein CHF causes anemia, and the anemia causes more CHF and both damage the kidneys worsening the anemia and the CHF further and increasing mortality. There is now evidence that early correction of the CHF anemia with subcutaneous erythropoietin and intravenous iron improves shortness of breath and fatigue, cardiac function, renal function and exercise capacity, reducing the need for hospitalization and improving quality of life.In the present review we discuss the data on current clinical use of erythropoietin in cardiovascular disease, with the main focus on the treatment of congestive heart failure, and summarize the advances and progress made in the understanding...

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Section: Adverse Effects Of Recombinant Erythro-poietinmentioning

confidence: 99%

Erythropoietin in Heart Failure and Other Cardiovascular Diseases: Hematopoietic and Pleiotropic Effects

Manolis¹,

Tzeis²,

Triantafyllou³

et al. 2005

CDTCHD

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“…All our patients presented anaemia and were using erithropoetin. This therapeutic approach has been associated with seizures and could justify the seizures in our patients that were using erithropoetin 19,20 .…”

Section: Discussionmentioning

confidence: 84%

Chronic Renal Insufficiency

Preedy¹,

Watson²

2010

Handbook of Disease Burdens and Quality of Life Measures

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“…Multicenter studies have shown an increase in the blood pressure during rHuEPO therapy with an incidence ranging from 12% to 35% in end-stage renal disease patients [6,7]. Possible factors underlying the mechanisms of erythropoietin-associated hypertension include increased systemic vascular resistance due to increased blood viscosity and loss of hypoxic vasodilation [6].…”

Section: Discussionmentioning

confidence: 99%

Hypertensive encephalopathy and reversible magnetic resonance imaging changes in a renal transplant patient

Dedeoglu

Springate

Najdzionek

et al. 1996

Pediatric Nephrology

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An 18-year-old renal transplant patient presented with sudden onset of seizures almost 2 years after she received the graft. Diagnostic work-up was unrevealing except for magnetic resonance imaging abnormalities of the brain that resolved spontaneously 4 weeks later. In this brief report, we discuss the etiology of the seizures and neurological abnormalities in renal transplant patients in light of the findings of our patient.

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Seizures in Dialysis Patients Treated with Recombinant Erythropoietin. Review of the Literature and Guidelines for Prevention

Cited by 41 publications

References 44 publications

Erythropoietin in Heart Failure and Other Cardiovascular Diseases: Hematopoietic and Pleiotropic Effects

Erythropoietin in Heart Failure and Other Cardiovascular Diseases: Hematopoietic and Pleiotropic Effects

Chronic Renal Insufficiency

Hypertensive encephalopathy and reversible magnetic resonance imaging changes in a renal transplant patient

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