Abstract
Following the administration of recombinant human erythropoietin (rHuEPO) to 18 patients undergoing hemodialysis. the hematocrit (Ht) increased from 19.7±1.8 to 31.0±2.0%. The incidence of hypertension according to the criteria of WHO was 11.1%. The systolic blood pressure (SBP) increased significantly from 120±21 to 129±26 mmHg (p<0.01) and diastolic blood. pressure (DBP) increased from 67±14 to 73±12mmHg (p<0.05). The cardiac Index (CI) decreased significantly from 4.07±1.13 to 3.56±0.88 L/min/m2 (p<0.05). Total peripheral resistance index (TPRI) and blood volume (BV) increased significantly from 1.725±406 to 2.170±643 dynes/sec/cm-5/m2 (p<0.001) and from 78.9±11.2 to 87.8±14.8ml/kg (p<0.005) respectively. Pulse rate (PR) decreased significantly from 73.0±10.7 to 65.9±7.8 beats/min (p<0.01). Patients who developed a blood pressure (BP) elevation of 10% or more for the mean blood pressure (MBP) showed a slight and insignificant decrease in CI from 3.65±1.12 to 3.49±1.06L/min/m2. which clearly contrasted to that in another group of patients who showed a reduced increase in MBP and a significant reduction in CI from 4.50±1.03 to 3.63±0.72L/min/m2 (p<0.05). Stroke volume index (SVI) was unchanged in both groups but PR decrease significantly in the latter group. A significant increase in TPRI or BV was observed equally in both groups. The change in MBP significantly correlated with that in CI in all cases (r=0.64, p<0.01). The present study indicates that the correction of anemia with rHuEPO is associated with an increase in TPRI in all cases in chronic hemodialysis patients and BP elevation is regulated by the change in CI.
