Nephrology Dialysis Transplantation, Vol 12, Issue 6 1155-1160, Copyright © 1997 by Oxford University Press
M Langenfeld, R Veelken, H Schobel, A Friedrich and R Schmieder
Background. Recent experimental studies have found
that erythropoietin elicits vasoconstriction and proliferation of
endothelial cells. We conducted the following study to assess the possible
interactions between endogenous erythropoietin, systemic and renal
haemodynamics at different stages of essential hypertension.
Method. We examined 47 patients with borderline
essential hypertension (age 26±3 years) and 49 patients with
established essential hypertension WHO stage I-II (age 52±10
years), and compared them to 42 normotensive individuals (age
26±3 years). The concentration of erythropoietin
(radioimmunoassay), 24-h ambulatory blood pressure (Spacelab 90207),
systemic haemodynamics (Doppler sonography) and renal haemodynamics
(para-aminohippuric acid and inulin clearance) were determined.
Results. Erythropoietin was within normal range and
similar among the three groups. In patients with established essential
hypertension, a close correlation was found between erythropoietin and
systolic (r=0.45, P<0.002)
and diastolic (r=0.51,
P<0.001) ambulatory blood pressure. In
contrast, ambulatory blood pressure was not correlated with erythropoietin
in subjects with borderline hypertension. Total peripheral resistance
(r=0.41, P<0.02) was
linked to erythropoietin in established but not in borderline hypertension.
However, erythropoietin was inversely correlated with renal plasma flow in
both established and borderline hypertension (r=-0.33,
P<0.05, and r=-0.34,
P<0.05 respectively). In normotensive subjects,
in contrast erythropoietin was not correlated with any of the determined
variables. In neither group erythropoietin was linked to the haematocrit or
hemoglobin concentration. Conclusion. The correlation
between erythropoietin and renal vascular changes which is already present
in borderline hypertension and is confirmed in established hypertension
indicates an involvement of erythropoietin in the development of essential
hypertension. The presence of normal concentrations of endogenous
erythropoietin in all groups suggests a dysregulation of erythropoietin in
patients with essential hypertension as the pathophysiological link between
erythropoietin and vascular changes. Keywords:
essential hypertension; erythropoietin; renal haemodynamics
ORIGINAL ARTICLES
Is endogenous erythropoietin a pathogenetic factor in the development of essential hypertension?
Department of Medicine IV/Nephrology, University of Erlangen-Nurnberg, Nurnberg, Germany; Corresponding author address: Medizinische Klinik IV/Nephrologie, Universitat Erlangen-Nurnberg, Breslauer Str. 201, D-90471 Nurnberg, Germany
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