The effect of recombinant human erythropoietin on cardiovascular responses to postural stress in dialysis patients
| Autor: | Leaker B, Neild Gh, C. H. Kong, Thompson Fd, M. E. Rogerson, E. Oviasu |
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| Rok vydání: | 1993 |
| Předmět: |
Adult
Male medicine.medical_specialty Cardiac output Baroreceptor Posture Hemodynamics Renal Dialysis Stress Physiological Internal medicine Diabetes mellitus Humans Medicine Erythropoietin Uremia Acidosis medicine.diagnostic_test Endocrine and Autonomic Systems business.industry Baroreflex Middle Aged Hypoxia (medical) medicine.disease Recombinant Proteins Impedance cardiography Anesthesia Cardiology Female Neurology (clinical) medicine.symptom business medicine.drug |
| Zdroj: | Clinical Autonomic Research. 3:271-274 |
| ISSN: | 1619-1560 0959-9851 |
| DOI: | 10.1007/bf01829017 |
| Popis: | The normal response to 45 degrees head-up tilt (decreased stroke volume and cardiac output and increased heart rate and peripheral resistance) is not seen in the majority of haemodialysis patients. This is due to both an abnormal baroreceptor reflex and increased venous tone which may be explained by a number of factors including hypoxia, acidosis and sodium retention. We have studied this response by impedance cardiography in eight chronic haemodialysis patients, both before and after 3 months of treatment with human recombinant erythropoietin. Before treatment the cardiovascular parameters were abnormal both at rest and on tilting in each patient. The change in each measurement following tilting was: stroke volume, 0.5 +/- 6%; cardiac output, 6 +/- 5%; peripheral resistance, -8 +/- 4%; and heart rate, 10 +/- 4%. After 3 months of erythropoietin (150 U/kg/week intravenously) the mean haematocrit had risen from 19.5 +/- 3% to 32.9 +/- 4% and all patients felt physically fitter. Impedance showed no change in the supine-indices but after tilting there was a dramatic fall in stroke volume (-26 +/- 7%) and cardiac output (-17 +/- 7%) and an increase in heart rate (15 +/- 4%) and peripheral resistance (28 +/- 10%) each moving towards the normal response. These results indicate that human recombinant erythropoietin normalizes the response to postural stress in these patients and suggest that anaemia is the principal cause of the abnormal venoconstriction seen in haemodialysis patients. The mechanisms involved warrant further investigation. |
| Databáze: | OpenAIRE |
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