Effect of erythropoietin on cardiovascular prognosis parameters in hemodialysis patients.


BACKGROUND:Renal anemia is an important determinant for left ventricular hypertrophy in dialysis patients and an independent prognosis parameter for the cardiovascular survival in dialysis patients. In addition, an autonomic dysfunction is associated with the uremic state and influences the cardiovascular risk in patients with end-stage renal disease (ESRD). METHODS:We investigated in this prospective longitudinal study the effect of hemoglobin normalization by a chronic treatment with recombinant human erythropoietin (rhEPO) on cardiovascular prognosis parameters in 23 patients on chronic hemodialysis with renal anemia (hemoglobin concentration < or =10.5 g/dL) and echocardiographically proven left ventricular hypertrophy. We studied muscle sympathetic nerve activity measured by microneurography; cardiopulmonary baroreflex activity by lower-body negative pressure (LBNP-) testing; left ventricular structure and mass index (LVMI) by echocardiography; blood pressure by 24-hour readings; peripheral blood flow and vascular resistance by plethysmography before (U1) and after 7 months of chronic rhEPO treatment (U2). RESULTS:In the anemic state, mean (+/- SD) muscle sympathetic nerve activity in ESRD was elevated (U1 rest, 34 +/- 13 bursts per minute) and cardiopulmonary baroreflex response during LBNP markedly lacking (U1 -15 mm Hg, 34 +/- 13 bursts per minute) reflecting a severely impaired autonomic function. Normalization of the hemoglobin concentration by chronic rhEPO treatment (U1, 10.5 +/- 0.9 g/dL versus U2, 13.4 +/- 3.1 g/dL, P <0.001) did not influence sympathetic nerve activity (U2, 34 +/- 15 bursts per minute, NS) and cardiopulmonary baroreflex sensitivity did not change (U2 -15 mm Hg, 37 +/- 16 bursts per minute, NS). LVMI decreased significantly after chronic treatment with rhEPO (U1, 134 +/- 26 g/m2 versus U2, 97 +/- 25 g/m2, P < 0.001) and left ventricular geometry developed from an asymmetric to a symmetric configuration (U1, relative wall thickness 0.58 versus U2, 0.43, P < 0.001). Under treatment with rhEPO, 24-hour systolic and diastolic blood pressure did not increase (systolic U1, 132 +/- 4 mm Hg versus U2, 128 +/- 3 mm Hg, NS, and diastolic U1, 76 +/- 2 mm Hg versus U2, 73 +/- 2 mm Hg, NS). Peripheral blood flow (U1, 6.1 +/- 3.3 mL/100 mL/min versus U2, 6.2 +/- 0.6 mL/100 mL/min, NS) as well as forearm vascular resistance (U1, 15.7 +/- 3.3 mm Hg/mL/100 mL versus U2, 14.9 +/- 3.1 mm Hg/mL/100 mL, NS) did not change by chronic rhEPO treatment. CONCLUSION:Normalization of hemoglobin by chronic rhEPO treatment in dialysis patients has beneficial cardiovascular effects with regression of left ventricular hypertrophy and improvement of left ventricular geometry. However, a reduction of sympathetic overactivity or a resetting of baroreceptor sensitivity by a rhEPO treatment in dialysis patients in the medium-term could not be demonstrated. The reason for this may be the complex and multifactorial pathomechanism of autonomic dysfunction and cardiovascular disease in ESRD.


Kidney Int


Kidney international


Frank H,Heusser K,Höffken B,Huber P,Schmieder RE,Schobel HP




Has Abstract


2004-08-01 00:00:00














  • High-affinity binding sites for VIP in renal cortical membranes: possible role of VIP in renal transport.

    abstract::We studied binding and degradation of vasoactive intestinal peptide (VIP) by highly purified brush border and basolateral membranes from rabbit kidney cortex. Brush border and basolateral membranes were capable of 73 and 49% degradation of VIP after 20 minutes, and the degradation was totally prevented by bacitracin. ...

    journal_title:Kidney international

    pub_type: 杂志文章


    authors: Kniaz D,Pahlavan P,Valaitis D,Arruda JA

    更新日期:1991-02-01 00:00:00

  • Nonsteroidal anti-inflammatory drug use is associated with cancer risk reduction in chronic dialysis patients.

    abstract::Previous studies have shown that nonsteroidal anti-inflammatory drug (NSAID) use might be associated with a lower risk of developing cancer in the general population. Patients on dialysis have increased risk for cancer, but there are no studies to determine the relationship between NSAID use and cancer risk in these p...

    journal_title:Kidney international

    pub_type: 杂志文章


    authors: Ou SM,Chen YT,Chao PW,Lee YJ,Liu CJ,Yeh CM,Chen TJ,Chen TW,Yang WC,Li SY

    更新日期:2013-07-01 00:00:00

  • Renal tubular basement membrane and collagen type IV in diabetes mellitus.

    abstract::The pathogenesis of the multiple structural lesions in diabetic nephropathy remains debated, and likely is multifactorial. The uniform thickening of the renal basement membranes lining the glomerular and tubular elements appears to be a consequence of the metabolic perturbations which are directly related to hyperglyc...

    journal_title:Kidney international

    pub_type: 杂志文章,评审


    authors: Ziyadeh FN

    更新日期:1993-01-01 00:00:00

  • Role of excess volume in the pathophysiology of hypertension in chronic kidney disease.

    abstract:BACKGROUND:The pathophysiology of hypertension in patients with chronic kidney disease (CKD) is largely attributed to positive sodium balance. It is unclear how loop diuretics affect fluid volume compartments, especially with respect to their antihypertensive effect. METHODS:Subjects with CKD were administered a singl...

    journal_title:Kidney international

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Vasavada N,Agarwal R

    更新日期:2003-11-01 00:00:00

  • Identification of a monocyte phagocytic defect in a subpopulation of patients with nephritis.

    abstract::Experimental studies have demonstrated the cardinal role played by the mononuclear phagocyte system in the removal of antigen-antibody complexes. To assess the functional capacity of phagocytes in patients with renal disease, 33 normal subjects, 10 patients with mesangial proliferative glomerulonephritis, 8 patients w...

    journal_title:Kidney international

    pub_type: 杂志文章


    authors: Ooi YM,Ooi BS

    更新日期:1983-06-01 00:00:00

  • Endothelial bound lipoprotein lipase (LpL) depletion in hypoalbuminemia results from decreased endothelial binding, not decreased secretion.

    abstract::Hypertriglyceridemia in nephrotic (NS) and Nagase analbuminemic rats (Analb) results from reduced triglyceride clearance. NS and Analb have reduced or absent albumin, reduced plasma oncotic pressure (pi), but Analb lack proteinuria. The heparin releasable lipoprotein lipase (LpL) pool in both models is greatly reduced...

    journal_title:Kidney international

    pub_type: 杂志文章


    authors: Shearer GC,Kaysen GA

    更新日期:2006-08-01 00:00:00

  • Prognostically controlled comparison of dialysis and renal transplantation.

    abstract::Because the comparison of survival in patients with renal failure treated by dialysis and transplantation may be biased by pretreatment prognostic differences in the patients who receive these two therapies, we quantified the pretreatment prognosis of all 430 dialysis and transplant patients who began therapy for end-...

    journal_title:Kidney international

    pub_type: 杂志文章


    authors: Hutchinson TA,Thomas DC,Lemieux JC,Harvey CE

    更新日期:1984-07-01 00:00:00

  • Dialysis costs: results of a diverse sample study.

    abstract::A study of dialysis costs in five major dialysis centers throughout the United States was conducted in 1973. When available, home, home training, limited care, satellite and in-hospital-full-care dialysis were included. The study's objective was to determine the cost per dialysis for each separate dialysis modality. A...

    journal_title:Kidney international

    pub_type: 杂志文章


    authors: Hoffstein PA,Krueger KK,Wineman RJ

    更新日期:1976-03-01 00:00:00

  • Inhibition of platelet-derived growth factor receptor tyrosine kinase by atrial natriuretic peptide.

    abstract::Atrial natriuretic peptide (ANP) is known to suppress platelet-derived growth factor (PDGF)-stimulated proliferation of rat cultured vascular smooth muscle cells. The present study examined whether ANP inhibits the PDGF receptor (PDGFR) tyrosine kinase activation, an initial event for PDGF cellular signaling. ANP redu...

    journal_title:Kidney international

    pub_type: 杂志文章


    authors: Awazu M

    更新日期:1997-08-01 00:00:00

  • Small proteoglycans of normal adult human kidney: distinct expression patterns of decorin, biglycan, fibromodulin, and lumican.

    abstract:BACKGROUND:Among the members of the small leucine-rich proteoglycan family, decorin, biglycan, and fibromodulin have been proposed to be potent modulators of transforming growth factor-beta (TGF-beta) activity, thereby playing an important role in the pathogenesis of fibrotic kidney diseases. Furthermore, decorin expre...

    journal_title:Kidney international

    pub_type: 杂志文章


    authors: Schaefer L,Gröne HJ,Raslik I,Robenek H,Ugorcakova J,Budny S,Schaefer RM,Kresse H

    更新日期:2000-10-01 00:00:00

  • Outcome and risk factors of ischemic heart disease in chronic uremia.

    abstract::To determine the prognosis and risk factors for ischemic heart disease in chronic uremia, a cohort of 432 dialysis patients were followed prospectively from start of dialysis therapy until death or renal transplantation. Baseline demographic, clinical and echocardiographic data were obtained. After the initiation of d...

    journal_title:Kidney international

    pub_type: 杂志文章


    authors: Parfrey PS,Foley RN,Harnett JD,Kent GM,Murray D,Barre PE

    更新日期:1996-05-01 00:00:00

  • Antibody-induced albuminuria and accelerated focal glomerulosclerosis in the Thy-1.1 transgenic mouse.

    abstract:BACKGROUND:Podocytes play an important role in the development of proteinuria and focal glomerulosclerosis. Previously we have demonstrated that a combination of two monoclonal antibodies (mAb) against aminopeptidase A (APA), an enzyme present on podocytes, induces a massive acute albuminuria in mice. The present study...

    journal_title:Kidney international

    pub_type: 杂志文章


    authors: Assmann KJ,van Son JP,Dïjkman HB,Mentzel S,Wetzels JF

    更新日期:2002-07-01 00:00:00

  • De novo pyrimidine nucleotide biosynthesis in isolated rat glomeruli.

    abstract::Uracil ribonucleotide-sugars and aminosugars are required for glomerular basement membrane (GBM) biosynthesis. Since these nucleotides are metabolic derivatives of uridine 5'-triphosphate (UTP), we have studied the cellular pools of uridine 5'-diphosphoglucose (UDPG), uridine 5'-diphosphoglucuronic acid (UDPGA), uridi...

    journal_title:Kidney international

    pub_type: 杂志文章


    authors: Cortes P,Dumler F,Levin NW

    更新日期:1986-07-01 00:00:00

  • Expanding the use of hepatitis C-viremic kidney donors.

    abstract::Direct-acting antivirals have revolutionized the treatment of hepatitis C virus (HCV) infection in patients with chronic kidney disease, with implications for the timing of antiviral treatment among kidney transplant candidates and for the use of HCV viremic donors. A recent consensus conference reviewed the available...

    journal_title:Kidney international

    pub_type: 评论,杂志文章


    authors: Sawinski D,Wyatt CM,Locke JE

    更新日期:2017-11-01 00:00:00

  • Control of renin gene expression in 2 kidney-1 clip rats.

    abstract::This study was done to investigate the mechanisms that underly the changes of renal renin gene expression upon hypoperfusion of one kidney. To this end the left renal arteries of male Sprague-Dawley rats were clipped with 0.2 mm silver clips and renal renin mRNA levels were assayed by RNase protection during the first...

    journal_title:Kidney international

    pub_type: 杂志文章


    authors: Schricker K,Holmer S,Krämer BK,Riegger G,Kurtz A

    更新日期:1994-12-01 00:00:00

  • Effect of dithiothreitol on mercuric chloride- and uranyl nitrate-induced acute renal failure in the rat.

    abstract::The current study was undertaken to examine the effects of dithiothreitol (DDT), a sulfhydryl-reducing agent and heavy metal chelator, on the course of heavy metal-induced acute renal failure in the rat. Groups of rats in metabolic cages received uranyl nitrate (UN) alone, UN plus DTT, mercuric chloride (HgCl2) alone,...

    journal_title:Kidney international

    pub_type: 杂志文章


    authors: Kleinman JG,McNeil JS,Schwartz JH,Hamburger RJ,Flamenbaum W

    更新日期:1977-08-01 00:00:00

  • Adrenergic modulation of extrarenal potassium disposal in men with end-stage renal disease.

    abstract::In normal subjects, beta-adrenergic stimulation lowers the serum potassium, whereas alpha-stimulation raises it. Epinephrine, a mixed alpha and beta agonist, acutely lowers the blood potassium in normal subjects, but not in patients with end-stage renal disease. This study was designed to determine whether the resista...

    journal_title:Kidney international

    pub_type: 杂志文章


    authors: Allon M,Shanklin N

    更新日期:1991-12-01 00:00:00

  • Morphometric study of glomerular slit diaphragms fixed by rapid-freezing and freeze-substitution.

    abstract::The widths of slit diaphragms in rat glomeruli were quantitatively measured on electron micrographs obtained by the rapid-freezing and freeze-substitution (FS) fixation method and compared to those prepared by conventional chemical fixation procedures, such as tannic acid, glutaraldehyde and osmium tetroxide (TGO) or ...

    journal_title:Kidney international

    pub_type: 杂志文章


    authors: Furukawa T,Ohno S,Oguchi H,Hora K,Tokunaga S,Furuta S

    更新日期:1991-10-01 00:00:00

  • Thrombomodulin ameliorates transforming growth factor-β1-mediated chronic kidney disease via the G-protein coupled receptor 15/Akt signal pathway.

    abstract::Kidney fibrosis is the common consequence of chronic kidney diseases that inexorably progresses to end-stage kidney disease with organ failure treatable only with replacement therapy. Since transforming growth factor-β1 is the main player in the pathogenesis of kidney fibrosis, we posed the hypothesis that recombinant...

    journal_title:Kidney international

    pub_type: 杂志文章


    authors: Takeshita A,Yasuma T,Nishihama K,D'Alessandro-Gabazza CN,Toda M,Totoki T,Okano Y,Uchida A,Inoue R,Qin L,Wang S,D'Alessandro VF,Kobayashi T,Takei Y,Mizoguchi A,Yano Y,Gabazza EC

    更新日期:2020-11-01 00:00:00

  • A non-nucleotide-bridged DNA decoy inhibits renal epithelial nitric oxide synthase expression.

    abstract:UNLABELLED:A non-nucleotide-bridged DNA decoy inhibits renal epithelial nitric oxide synthase expression. BACKGROUND:The expression of inducible nitric oxide synthase (iNOS) is subject to strict tissue-specific transcriptional control. In mouse renal epithelium, an interferon-gamma (IFN-gamma)-induced signaling protei...

    journal_title:Kidney international

    pub_type: 杂志文章


    authors: Amoah-Apraku B,Fang MZ,Guzman NJ

    更新日期:2000-01-01 00:00:00

  • Effect of conjugated estrogens on platelet function and prostacyclin generation in CRF.

    abstract::In a double-blind, randomized, placebo-controlled cross-over study, we investigated in seven patients with chronic renal failure the effect of conjugated estrogens (0.6 mg/kg/day for 5 days) on template bleeding time and on thromboxane A2 (TxA2), beta-thromboglobulin (beta-TG) and prostacyclin (PGI2) concentrations in...

    journal_title:Kidney international

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Heistinger M,Stockenhuber F,Schneider B,Pabinger I,Brenner B,Wagner B,Balcke P,Lechner K,Kyrle PA

    更新日期:1990-12-01 00:00:00

  • Decreased ATPase activity in adriamycin nephrosis is independent of proteinuria.

    abstract::In previous studies from this laboratory it has been shown that ATP-ase activity in situ in the glomerular basement membrane (GBM) is clearly reduced in rats rendered nephrotic after treatment with adriamycin (ADR). The question was raised whether this reduction of ATP-ase activity in the GBM is due to toxic activity ...

    journal_title:Kidney international

    pub_type: 杂志文章


    authors: Bakker WW,Kalicharan D,Donga J,Hulstaert CE,Hardonk MJ

    更新日期:1987-03-01 00:00:00

  • Increased susceptibility to erythrocyte C5b-9 deposition and complement-mediated lysis in chronic renal failure.

    abstract:BACKGROUND:Decreased red blood cell survival contributes to the anemia of chronic renal failure patients. Because patients on chronic dialysis therapy are frequently exposed to excessive complement activation, we investigated the susceptibility of this patient population to erythrocyte C5b-9 deposition, complement-medi...

    journal_title:Kidney international

    pub_type: 杂志文章


    authors: Himmelfarb J,McMonagle E,Holbrook D,Hakim R

    更新日期:1999-02-01 00:00:00

  • Dietary potassium influences kidney maintenance of serum phosphorus concentration.

    abstract::In studying the metabolic effects of diet potassium (K+) variation in normal humans, we noted that varying diet K+ within its normal range influenced inorganic phosphorus (Pi) homeostasis and serum calcitriol (1,25-dihydroxyvitamin D) levels. In six men who ingested a constant whole-foods diet containing (per 70 kg bo...

    journal_title:Kidney international

    pub_type: 杂志文章


    authors: Sebastian A,Hernandez RE,Portale AA,Colman J,Tatsuno J,Morris RC Jr

    更新日期:1990-05-01 00:00:00

  • Presence of an anti-viral factor in peritoneal dialysis effluent.

    abstract::Viral peritonitis is an exceptionally rare occurrence in peritoneal dialysis. In fact, up to now, only one case report has been documented in the literature. In a prospective study, peritoneal dialysis effluent (PDE) was specifically cultured for the following viruses: the herpes group of viruses, including herpes sim...

    journal_title:Kidney international

    pub_type: 杂志文章


    authors: Pomeranz A,Korzets Z,Smetana O,Yuhas Y,Elan I,Bernheim J

    更新日期:1989-08-01 00:00:00

  • Epidemiology of atherosclerotic renal artery stenosis as a mirror of prospective trials.

    abstract::Diagnosis and treatment of atherosclerotic renal artery stenosis (ARAS) in the elderly is a never-ending challenge for every nephrologist. Kalra et al. report that adjusted hazard ratios for ARAS increased threefold from 1992 to 2004 in 16 million United States Renal Data System participants aged 66 years or older. Ho...

    journal_title:Kidney international

    pub_type: 信件


    authors: Krumme B

    更新日期:2010-01-01 00:00:00

  • Effects of reduced renal function and dietary protein on muscle protein synthesis.

    abstract::We describe a rat model of renal failure that separates catabolic and anabolic states from each other. Muscle protein synthesis was compared during the anabolic period between sham (S) operated and renal failure (RF) rats that were fed different levels of dietary protein. Male rats weighing between 60 and 80 g first h...

    journal_title:Kidney international

    pub_type: 杂志文章


    authors: Baliga R,George VT,Ray PE,Holliday MA

    更新日期:1991-05-01 00:00:00

  • Proinflammatory gene expression and macrophage recruitment in the rat remnant kidney.

    abstract:BACKGROUND:Macrophage (Mphi) infiltration may contribute to chronic renal injury. We therefore sought to examine the expression of genes associated with Mphi recruitment in the rat remnant kidney model. METHODS:Male Munich Wistar rats underwent 5/6 nephrectomy or sham operation (SHM, N = 18) and received no treatment ...

    journal_title:Kidney international

    pub_type: 杂志文章


    authors: Taal MW,Zandi-Nejad K,Weening B,Shahsafaei A,Kato S,Lee KW,Ziai F,Jiang T,Brenner BM,MacKenzie HS

    更新日期:2000-10-01 00:00:00

  • Effect of fluvastatin on renal end points in the Assessment of Lescol in Renal Transplant (ALERT) trial.

    abstract:BACKGROUND:Hyperlipidemia is a risk factor for long-term renal transplant dysfunction, but no prospective clinical trials have investigated the effects of statin treatment on graft function in renal transplant recipients. The aim of the present study was to evaluate the effect of fluvastatin on long-term renal transpla...

    journal_title:Kidney international

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Fellström B,Holdaas H,Jardine AG,Holme I,Nyberg G,Fauchald P,Grönhagen-Riska C,Madsen S,Neumayer HH,Cole E,Maes B,Ambühl P,Olsson AG,Hartmann A,Logan JO,Pedersen TR,Assessment of Lescol in Renal Transplantation Study Inve

    更新日期:2004-10-01 00:00:00

  • Familial nephrotic syndrome: clinical spectrum and linkage to chromosome 19q13.

    abstract:BACKGROUND:Familial nephrotic syndrome (NS) has both autosomal dominant and recessive forms of inheritance. Recent studies in families with an autosomal dominant form of focal segmental glomerulosclerosis (FSGS) have been at odds concerning linkage to chromosome 19q13 (Mathis et al, Kidney Int 53:282-286, 1998; Winn et...

    journal_title:Kidney international

    pub_type: 杂志文章


    authors: Vats A,Nayak A,Ellis D,Randhawa PS,Finegold DN,Levinson KL,Ferrell RE

    更新日期:2000-03-01 00:00:00