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Keywords. hypertension, erythropoietin, end-stage renal disease, hemodialysis
Introduction. Anemia is among the most important complications of chronic kidney disease (CKD) and a lot of symptoms and signs are due to this problem. Erythropoietin injection may improve anemia, but it may cause hypertension in these patients. The aim of this study is to evaluate erythropoietin injection effects on blood pressure of hemodialysis and predialysis patients.
Materials and Methods. Forty hemodialysis patients and 40 predialysis patients with end-stage renal disease were enrolled in the study. The studied patients were comparable in terms of age, sex, hemoglobin, serum calcium, and baseline blood pressure. Erythropoietin was injected for all of the patients with anemia (4000 U, twice weekly). The effect of erythropoietin on their blood pressure was evaluated for each group by comparison of systolic, diastolic, and mean arterial blood pressure values before and 1 hour after the injection.
Results. After erythropoietin injection, systolic, diastolic, and mean arterial blood pressure values increased significantly in the hemodialysis group, and the increases were significantly greater in this group than the predialysis group (P = .02, P = .01, and P = .02, respectively). Blood pressure increase was significant only for the systolic component in the predialysis group.
Conclusions. Erythropoietin injection increases blood pressure levels in both groups. However, this is more significant in the hemodialysis patients as compared with patients with end-stage renal disease who have not started dialysis. Monitoring of blood pressure after erythropoietin injection is recommended.
IJKD 2013;7:220-5
www.ijkd.org
INTRODUCTION
Anemia is one of the most important complications of end-stage renal disease (ESRD), and a lot of symptoms and signs in dialysis patients are related to this problem.1,2 Anemia predicts mortality of patients with ESRD. It has many pathophysiologic effects on these patients.3 Tissue oxygenation impairment, leftventricular hypertrophy, angina pectoris, heart failure, and so many immunological problems may be induced by anemia.4 When kidney function drops below 30%, erythropoietin secretion reduces and it finally cause anemia. Iron, folic acid, and other supplements cannot solve this problem, until erythropoietin administration. Anemia will be corrected remarkably by accurate administration of synthetic erythropoietin in hemodialysis patients.5
Erythropoietin injection may induce or exacerbate hypertension. This is an unwanted side effect in patients with chronic kidney damage, because it is hard to...