Influence of the 6‑month anemia therapy with erythropoietin on renal function and some hemodynamic parameters in predialysis patients

Objectives The aim of this study was to evaluate the influence of a 6‑month anemia therapy with recombinant human erythropoietin (rHuEpo) on glomerular filtration rate (GFR) and renal blood flow related to hemoglobin (Hb) concentration, changes in heart function and total peripheral resistance in patients with chronic kidney disease (CKD) treated conservatively.
Patients and methods We evaluated 13 patients (9 women and 4 men) aged 64.8 ±8.9 years with serum creatinine of 3.82 ±1.30 mg/dl and Hb concentration of 10.02 ±0.45 g/dl. rHuEpo was given in the mean dose of 2296 ±673 U/week s.c. to achieve Hb 12 g/dl. At baseline and after 6 months of rHuEpo therapy echocardiography and renoscintigraphy were performed.
Results After 6 months’ therapy Hb increased significantly, while blood pressure did not change significantly. Renal anemia correction led to a decrease in left ventricular end‑diastolic dimension index, left ventricular end‑diastolic volume index, stroke volume index and cardiac index. Total peripheral vascular resistance index increased significantly. At the same time a significantly reduced left ventricular mass index was observed. Correction of renal anemia and changes in systemic hemodynamics did not exert unfavorable effect on renal hemodynamic parameters. GFR index, blood flow rate index, renal vascular resistance index and filtration fraction remained unchanged. During rHuEpo therapy decline in renal function expressed as 1/serum creatinine did not differ compared with a 6‑month period before initiating rHuEpo therapy.
Conclusions Therapy with rHuEpo in patients with stage 3 and 4 CKD with correct blood pressure control does not result in worsening of renal function despite changes in left ventricular function and increase of total peripheral resistance.