Document Detail


Effect of hemoglobin levels in hemodialysis patients with asymptomatic cardiomyopathy.
MedLine Citation:
PMID:  10972697     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Hemoglobin levels below 10 g/dL lead to left ventricular (LV) hypertrophy, LV dilation, a lower quality of life, higher cardiac morbidity, and a higher mortality rate in end-stage renal disease. The benefits and risks of normalizing hemoglobin levels in hemodialysis patients without symptomatic cardiac disease are unknown. METHODS: One hundred forty-six hemodialysis patients with either concentric LV hypertrophy or LV dilation were randomly assigned to receive doses of epoetin alpha designed to achieve hemoglobin levels of 10 or 13.5 g/dL. The study duration was 48 weeks. The primary outcomes were the change in LV mass index in those with concentric LV hypertrophy and the change in cavity volume index in those with LV dilation. RESULTS: In patients with concentric LV hypertrophy, the changes in LV mass index were similar in the normal and low target hemoglobin groups. The changes in cavity volume index were similar in both targets in the LV dilation group. Treatment-received analysis of the concentric LV hypertrophy group showed no correlation between the change in mass index and a correlation between the change in LV volume index and mean hemoglobin level achieved (8 mL/m2 per 1 g/dL hemoglobin decrement, P = 0.009). Mean hemoglobin levels and the changes in LV mass and cavity volume index were not correlated in patients with LV dilation. Normalization of hemoglobin led to improvements in fatigue (P = 0.009), depression (P = 0.02), and relationships (P = 0.004). CONCLUSIONS: Normalization of hemoglobin does not lead to regression of established concentric LV hypertrophy or LV dilation. It may, however, prevent the development of LV dilation, and it leads to improved quality of life.
Authors:
R N Foley; P S Parfrey; J Morgan; P E Barré; P Campbell; P Cartier; D Coyle; A Fine; P Handa; I Kingma; C Y Lau; A Levin; D Mendelssohn; N Muirhead; B Murphy; R K Plante; G Posen; G A Wells
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Kidney international     Volume:  58     ISSN:  0085-2538     ISO Abbreviation:  Kidney Int.     Publication Date:  2000 Sep 
Date Detail:
Created Date:  2000-10-12     Completed Date:  2000-10-12     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0323470     Medline TA:  Kidney Int     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1325-35     Citation Subset:  IM    
Affiliation:
The Health Sciences Center, Memorial University of Newfoundland, Saint John's, UK. rn_foley@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Anemia / drug therapy,  etiology
Cardiac Volume
Cardiomyopathy, Dilated / complications*,  prevention & control*,  ultrasonography
Echocardiography
Erythropoietin / administration & dosage
Female
Hemoglobins*
Humans
Hypertrophy, Left Ventricular / complications,  prevention & control,  ultrasonography
Kidney Failure, Chronic / complications*,  psychology,  therapy*
Male
Middle Aged
Myocardial Ischemia / complications,  prevention & control,  ultrasonography
Patient Satisfaction
Quality of Life
Questionnaires
Renal Dialysis*
Thrombosis
Chemical
Reg. No./Substance:
0/Hemoglobins; 11096-26-7/Erythropoietin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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