Effects of Short-Term Partial Correction of Anemia in End-Stage Renal Disease (ESRD) Patients on Maintenance Hemodialysis : Changes of Amino-Terminal Pro B-type Natriuretic Peptide (NT-pro BNP) and Echocardiographic Parameters

Ryu, Dong Ryeol; Ryu, Jung Hwa; Bae, Ki Sun; Yu, Mina; Lim, Jong Baeck; Kim, Seung Jung; Pyun, Wook Bum; Choi, Kyu Bok; Shin, Gil Ja; Yoon, Kyun Il; Kang, Duk Hee

Abstract

BACKGROUND: Anemia is known to be one of the important risk factors in the development and the aggravation of cardiovascular diseases. This study was undertaken to evaluate the effect of anemia correction on blood NT-pro BNP level and echocardiographic parameters in ESRD patients on hemodialysis.
METHODS
Recombinant human erythropoietin (rHuEPO) was administered in 20 hemodialysis patients (median age 51.5, M:F=2.3:1) with a target hemoglobin>12.0 g/dL for 3 months. All patients were subjected to a serial follow-up of hemoglobin, hematocrit, and NT-pro BNP. Echocardiographic examination was also performed before and after 3 months of therapy.
RESULTS
Hemoglobin was increased at 3 months [12.3 g/dL (11.8-13.6)] compared with baseline [9.8 g/dL (9.1-10.4)] (p<0.01), and NT-pro BNP was significantly decreased at 3 months [3415 pg/mL (2717- 8160)] compared with baseline [6371 pg/mL (2338- 18269)] (p<0.05). Echocardiographic examination revealed no significant changes in left ventricular ejection fraction and left ventricular mass index. In Doppler imaging, however, there was significant decrease in E velocity [62.5 cm/sec (52.8-83.5) vs. 57.0 cm/sec (45.0-60.0), p<0.05], thereby decrement in E/E' [15.6 (13.4-25.7) vs. 14.3 (11.5-22.2), p<0.05].
CONCLUSION
Partial correction of anemia with rHuEPO in ESRD patients on hemodialysis results in the reduction of blood NT-pro BNP level and the decrease of E velocity and E/E'.