만성 신부전 환자에서 Recombinant Human Erythropoietin ( rHuEPO ) 투여에 따른 심장의 기능 및 형태학적 변화

• Published in: Kidney research and clinical practice Vol. 12; no. 1; pp. 62 - 67
• Main Authors: 박원도, 송일환, 강흥선, 안재형, 이태원, 임천규, 배종화, 김명재
• Format: Journal Article
• Language: Korean
• Published: 대한신장학회 01.03.1993
• ISSN: 2211-9132

Background:Hemodynamic changes often occur in patients with chronic renal failure. Hyperdynamic state is probably contributory determinent of the congestive uremic cardiomyopathy in these patients. Renal anemia is the most important factor in these changes. Methods: Using echocardiography, we evaluated the hemodynamic changes in thirteen patients with severe renal anemia (Hct<23%) before and after treatment with recombinant human erythropoietin (rHuEPO). Thirteen patients on maintenance hemodialysiswere treated with rHuEPO 50IU/kg intravenously three times per week for twelve weeks. Results: Under rHuEPO treatment, hematocrit rose from 19.8±1.8% to 30.4±2.5% (p<0.01) and blood pres- sure significantly increased (p<0.05). Left vetricular dimension and volume were decreased but not signifi- cantly. Cardiac wall thickness was unchanged during study period. Posttreatment cardiac index was de- creased (5.5±1.6 vs 4.3±1.3 liter/min/m) when compar- ed with pretreatment period (p<0.05). Concluaion: This study suggested that partial correc- tion of renal anemia by rHuEPO therapy results in improvement of hemodynamic impairment in patients with congestive uremic cardiomyopathy. The decrease of cardiac index might well be a result of improved cardiac funtion and peripheral vasoconstriction due to increased oxygen availability.