The effect of erythropoietin treatment on left ventricular hypertrophy in haemodialysis patients

Abstract

Anaemia appears to play an important role in left ventricular (LV) enlargement in chronic kidney disease patients. The objective of this study was to evaluate LV echocardiography changes during anaemia correction with recombinant human erythropoietin (rHu-Epo) in chronic haemodialysis patients (HD pts) with signs of anaemia and LV hypertrophy (LVH). The study included 20 HD pts aged 39,6 +/- 5,3 yrs, with the same condition of HD treatment, anaemia and echocardiographically LVH verified. At the beginning of the rHu-Epo treatment haemoglobin (Hb) level was < 90 g/L and the target Hb level was 110 g/L. Echocardiography was performed at the beginning (baseline) and after six months of rHu-Epo treatment. LVH was defined as LV mass index >100 g/m2 in women and >131 g/m2 in men. We observed significant reduction of LV mass index (LVMI) (mean 26,4%, p=0.008), as well as LV volumen. There was a significant negative correlation between Hb level and LVMI with predictive LVMI reduction of 2,317 g/m2 for each 1g/L rising of mean Hb level. The results of the study confirm the importance of early anaemia correction in haemodialysis patients aimed to improve LV parameters.

Reviews: Is Regression of Left Ventricular Hypertrophy in Maintenance Hemodialysis Patients Possible?

“…Similarly, in nine normotensive dialyzed patients studied before and 3 and 6 months after start of intravenous treatment with recombinant human erythropoietin, LVMI decreased significantly with the increase in Hb (115 ± 18 vs. 78 ± 13 g/m 2 body surface area) (15). In 20 HD patients with anemia receiving erythropoietin for 6 months, LVMI and LV volume decreased significantly and a LVMI reduction of 2.3 g/m 2 occurred for each 1 g/l increase in Hb level (16). In another study, erythropoietin administration significantly decreased LVMI (296.6 ± 62.4 vs. 225.2 ± 52.7 g/m 2 body surface area) but that following its cessation LVMI increased again (311.7 ± 106 g/m 2 body surface area) (16).…”

“…In 20 HD patients with anemia receiving erythropoietin for 6 months, LVMI and LV volume decreased significantly and a LVMI reduction of 2.3 g/m 2 occurred for each 1 g/l increase in Hb level (16). In another study, erythropoietin administration significantly decreased LVMI (296.6 ± 62.4 vs. 225.2 ± 52.7 g/m 2 body surface area) but that following its cessation LVMI increased again (311.7 ± 106 g/m 2 body surface area) (16).…”