Influence of recombinant human erythropoietin on central haemodynamics in haemodialysis patients

The aim of study was to investigate the haemodynamic changes developing after short-term rHuEPO administration before the clinically significant correction of anaemia. 12 patients (pts) on maintenance haemodialysis received rHuEPO for 4 months in dose 20-40 U/kg b.w. thrice weekly subcutaneously. Central haemodynamic parameters: systolic volume (SV), cardiac output (CO), total peripheral vascular resistance (TPVR), systolic blood pressure (SBP), mean blood pressure (MBP), diastolic blood pressure (DBP), heart rate (HR) were measured 3 times - before the starting of treatment (control), after 4-6 weeks of treatment, but before target hemoglobin (> 11 g/dl) and haematocrit (> 30%) were reached (EPO-1 period), and after 4 months of treatment when target HE and HT were achieved (EPO-2 period). In accordance with purpose of study detailed analysis was made only for data in EPO-1 period. Two opposite types of cardiovascular response were identified after short term rHuEPO application. 'Hyperkinetic' type (5 pts) - with elevation CO, SV and decrease of TPVR; and 'hypodynamic' type (7 pts) - with reduction of CO, SV and increase of TPVR. Conclusion: the short-term application of rHuEPO does not affect any definite cardiovascular function, but induces strain of regulatory system, possibly, by involvement of autonomic nervous system and renin-angiotensin-aldosteron system.