Hemorheological and hemodynamic changes in predialysis patients after normalization of hemoglobin with epoetin-alpha.

Objective. Changes in blood viscosity and total peripheral resistance may contribute to increased blood pressure during partial correction of renal anemia with erythropoietin. An increase in hemoglobin level is followed by decreases in cardiac output and left ventricular mass. We examined how normalization of hemoglobin in predialysis patients affects both hemorheological and hemodynamic variables. Material and methods. Twelve moderately anemic predialysis patients (hemoglobin 115.9±7.8 g/l) received epoetin-α with the aim of achieving a normal hemoglobin level (135–160 g/l). Hemorheological variables were measured using rotational viscometry. Cardiac index was determined by means of Doppler echocardiography. Results. After 48 weeks, the hematocrit level had increased from 37.9%±3.0% to 47.0%±3.1% (p<0.0001). Blood viscosity increased from 3.84±0.33 to 4.59±0.4 mPa×s (p<0.001). Blood viscosity standardized to a hematocrit level of 45% and a plasma viscosity of 1.31 mPa×s did not change. Plasma viscosity, ...