Document Detail

High-dose intravenous epoetin does not increase blood pressure in critically ill patients with acute kidney injury.
MedLine Citation:
PMID:  23320967     Owner:  NLM     Status:  Publisher    
Aims: Treatment of renal anemia with erythropoietic stimulating agents sometimes increases blood pressure. It is uncertain whether this is due to direct vasoconstriction and/or increased red blood cell mass. Materials and methods: We conducted a post-hoc analysis of 160 critically ill patients in the EARLYARF trial with elevated urinary γ-glutamyltranspeptidase and alkaline phosphatase, indicating acute kidney injury. Patients received 2 doses of intravenous (i.v.) epoetin (500 U/kg), 24 hours apart, or placebo, in a randomized, double-blind study design. Hourly intra-arterial mean arterial pressure (MAP), and norepinephrine equivalent dose (NED: determined using equipotency conversion factors for doses of epinephrine, vasopressin, phenlyephrine, or dopamine) were extracted from clinical records. The differences between baseline and maximum MAP and NED (ΔMAP and ΔNED) over 4, 24, 72-hour, and 30-day periods following study drug administration were compared between groups. Results: At baseline, MAP was 78 ± 14 mmHg in the epoetin group and 81 ± 15 mmHg in the placebo group (p = 0.22). There were no differences between groups in ΔMAP (6 ± 14 versus 7 ± 14 mmHg; p = 0.53), in ΔNED, or in ΔMAP adjusted for ΔNED at 4 hours, or at any time points. A subgroup analysis of only those patients not requiring vasopressor support (n = 71) also showed no differences between epoetin and placebo for all outcomes. Conclusion: We concluded that intravenous high dose epoetin does not acutely increase blood pressure, suggesting no acute vasoconstrictor effect in this setting.
Azrina M Ralib; John W Pickering; Tamas Major; Suetonia C Palmer; Geoffrey M Shaw; David A Goodkin; Zoltán H Endre
Related Documents :
3038667 - The effects of parenteral injections of adenosine and its analogs on blood pressure and...
9151287 - Vascular chemical sulfhydryl alkylation in vitro: alterations in intracellular calcium ...
11451597 - Metabolic disorder in myocardiac intracellular free calcium after thermal injury.
21135797 - The clinical effectiveness of negative pressure wound therapy: a systematic review.
2590907 - Mechanism of the apparent parasympathetic inhibition of adenosine induced heart rate sl...
3760387 - Pulmonary vascular supersensitivity to catecholamines in systemic high blood pressure.
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-15
Journal Detail:
Title:  Clinical nephrology     Volume:  -     ISSN:  0301-0430     ISO Abbreviation:  Clin. Nephrol.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0364441     Medline TA:  Clin Nephrol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

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

Previous Document:  Elevated serum Cystatin C at continuous renal replacement therapy initiation predicts lack of renal ...
Next Document:  What can we learn from a patient on dialysis for 42 years?