Background
Cardiovascular disease is a significant complication in chronic kidney disease and a
major cause of death in dialysis patients. Anemia is associated with reduced
survival in patients with renal disease, and anemia is independently associated
with an increased risk of cardiovascular disease. The body adapts to anemia by
increasing cardiac output, which may result in cardiac remodeling and progression
of left ventricular (LV) growth.
Aim
The aim of this study was to shed light on the effects of correction of anemia after
therapy with recombinant human erythropoietin (rHuEPO) on left ventricular
hypertrophy (LVH) and consequently LV function in dialysis patients. So we
studied 40 hemodialysis patients with hemoglobin (Hb) less than 10 g/dl as well
as 10 age-matched and sex-matched hemodialysis patients with Hb more than
11 g/dl who never received erythropoietin as a control group.
Patients and methods
All participants of the study were subjected to full medical history, thorough medical
examination, and investigations including complete blood count, serum ferritin, and
echocardiography.
Results
A significant increase in Hb, packed cell volume (PCV%), and red blood cells
(RBCs) count was seen at all months of the study period, with mean Hb at the start
of the study being 7.96±0.72 g/dl and at the end of treatment being 10.67±0.83 g/dl.
There is a significant increase in ejection fraction (EF%) with significant reduction in
left ventricular mass index (LVMI) after treatment in comparison with pretreatment,
which means improvement of cardiac function and reduction of LVH after treatment
with rHuEPO.
Conclusion
This prospective study showed that correction of anemia with rHuEPO in the
patients undergoing hemodialysis with Hb level less than 10 g/dl led to
correction of LVH, with improvement of the cardiac function. |
