Evidence for renal vasodilation in pre-dialysis patients during correction of anemia by erythropoietin
| Autor: | Jack F.M. Wetzels, Robert A.P. Koene, Leon A. M. Frenken, Henk E. Sluiter |
|---|---|
| Rok vydání: | 1992 |
| Předmět: |
Adult
Male medicine.medical_specialty Captopril Urology Renal function PAH clearance Hematocrit Kidney Renal Circulation hemic and lymphatic diseases Internal medicine Humans Medicine Erythropoietin Aged medicine.diagnostic_test business.industry Anemia Effective renal plasma flow Middle Aged Recombinant Proteins Filtration fraction Vasodilation Endocrinology Nephrology Renal blood flow Female business Dialysis circulatory and respiratory physiology medicine.drug |
| Zdroj: | Kidney International. 41:384-387 |
| ISSN: | 0085-2538 |
| DOI: | 10.1038/ki.1992.53 |
| Popis: | Evidence for renal vasodilation in pre-dialysis patients during correction of anemia by erythropoietin. Results from animal experiments have suggested that treatment with recombinant human erythropoietin (rHuEPO) causes changes in renal hemodynamics which are detrimental to renal function. Therefore, the effects of correction of the anemia by rHuEPO on glomerular filtration rate (GFR; inulin clearance) and effective renal plasma flow (ERPF; PAH clearance) were studied in eight pre-dialysis patients. The studies were done before (Hct 0.24 ± 0.05 liter/liter) and at 89 ± 19 days after the start of rHuEPO therapy (Hct 0.39 ± 0.03 liter/liter). To further evaluate the effects of ACE inhibition, 25 mg of captopril was given orally after baseline values had been obtained. Baseline GFR, renal blood flow (RBF) and filtration fraction (FF) did not change during rHuEPO therapy. At low hematocrit (Hct) captopril induced a significant increase in ERPF and RBF, and a decrease in MAP. After correction of the hematocrit the blood pressure lowering effect of captopril remained unchanged. However, captopril no longer induced changes in ERPF and RBF. We conclude that the increase in hematocrit had no adverse effects on GFR. The results suggest that changes in hematocrit may influence the effects of ACE inhibition on efferent vascular resistance. Therefore, the hematocrit should be taken into account when evaluating studies on the effects of ACE inhibition in the progression of chronic renal failure. |
| Databáze: | OpenAIRE |
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