Effects of recombinant human erythropoietin on echocardiographic findings in elderly dialysis patients

Twenty anaemic, normotensive and elderly patients on both haemodialysis and CAPD with left ventricular hypertrophy (LVH) were undergoing systematic echocardiographic analysis during treatment with recombinant human erythropoietin (rHuEPO) for 12 months. Before and after the rHuEPO treatment, M-mode and pulsed Doppler echocardiographic were performed and haemodynamic parameters were closely followed. Partial correction of anaemia resulted in a decrease in the LV end-diastolic diameter (LVEDD) from 56.0 +/- 2.0-49.2 +/- 2.0 mm (P<0.05) in HD patients and 50.5 +/- 4.0-43.6 +/- 3.0 mm in CAPD patients (P = NS). Concomitantly the calculated mass index (LVMi) was reduced significantly from 232.3 +/- 21.8-185.9 +/- 11.4 g/m(2) in elderly haemodialysis patients. Heart rate and arterial pressure did not change during the study period. However, in CAPD patients there was no significant change in LVMi during the study period. We conclude that long-term amelioration of anaemia in dialysis patients could induce a regression of left ventricular hypertrophy. However, in CAPD patients, both myocardial and haemodynamic effects were less evident. CAPD could possibly modulate the haemodynamic changes associated with the rHuEPO treatment or CAPD itself impose less left ventricular wall stress in these elderly patients.