Document Detail


Erythropoietin and systemic hypertension.
MedLine Citation:
PMID:  7644110     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Systemic hypertension has been reported to develop, or to worsen, in 20-30% of patients treated with recombinant human erythropoietin (r-HuEPO) worldwide. The greatest increases in blood pressure affect day-time systolic and night-time diastolic blood pressure. Hypertension may develop in some patients as early as 2 weeks and in others as late as 4 months after the start of r-HuEPO treatment. In haemodialysis patients with systemic hypotension, r-HuEPO usually induces a 10% increase in blood pressure, with no significant change in the frequency of hypotensive episodes. Several risk factors for the development, or worsening, of hypertension after r-HuEPO therapy have been identified. They include the presence of pre-existing hypertension, rapid increase in haematocrit, a low baseline haematocrit before r-HuEPO administration, high doses and i.v. route of administration, the presence of native kidneys, a genetic predisposition to hypertension, and possibly a younger age. There are several potential mechanisms by which r-HuEPO therapy may increase blood pressure in haemodialysis patients. They include increased blood viscosity; the loss of hypoxic vasodilation; the activation of neurohumoral systems (catecholamines, the renin-angiotensin system); and especially a direct vascular effect. This last mechanism is supported by several data, and many factors may be involved in its pathogenesis (an increased cell calcium uptake; an imbalance in local vasoactive agents, with increased synthesis of ET-1; a mitogenic effect; and a platelet-dependent mechanism).
Authors:
G Maschio
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association     Volume:  10 Suppl 2     ISSN:  0931-0509     ISO Abbreviation:  Nephrol. Dial. Transplant.     Publication Date:  1995  
Date Detail:
Created Date:  1995-09-21     Completed Date:  1995-09-21     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  8706402     Medline TA:  Nephrol Dial Transplant     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  74-9     Citation Subset:  IM    
Affiliation:
Division of Nephrology, University Hospital, Verona, Italy.
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MeSH Terms
Descriptor/Qualifier:
Blood Viscosity / drug effects
Calcium / metabolism
Erythropoietin / adverse effects*
Humans
Hypertension / chemically induced*
Recombinant Proteins / adverse effects
Vasodilation / drug effects
Chemical
Reg. No./Substance:
0/Recombinant Proteins; 11096-26-7/Erythropoietin; 7440-70-2/Calcium

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


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