Nephrology Dialysis Transplantation, Vol 14, Issue 90002 29-36, Copyright © 1999 by Oxford University Press
J Mann
There is a clear relationship between anaemia and cardiovascular risk in
chronic renal failure (CRF) patients. Left ventricular hypertrophy (LVH) is
present in about three-quarters of patients starting dialysis, and is a
strong predictor of mortality. Anaemia contributes to The development of
LVH, mainly Via increased cardiac output. In some patients, anaemia results
in an increase in LV mass, while in others it also results in LV
end-diastolic volume dilatation. These changes increase The risk of
arrhythmias, myocardial infarction and myocardial fibrosis. The lower The
haemoglobin, The more likely it is that LVH and heart failure will develop.
Furthermore, a haemoglobin of <11 g/dl is associated with increased
morbidity and mortality. Partial correction of anaemia with epoetin leads
to a partial, but not complete, reversal of LVH. One large retrospective
study (Lombardy Registry) found that epoetin use was accompanied by a 30%
reduction in crude relative risk of mortality. A progressive reduction in
The relative risk of general and cardiovascular mortality was found with
increasing haematocrit, with and without adjustment for co-morbid
conditions. Mean hospitalizations also decreased with increasing
haematocrit. The long-term effects of normalized haematocrit/haemoglobin
values in uraemic patients have not yet been evaluated exhaustively in
prospective, randomized, multicentre studies. Epoetin treatment has been
shown to induce lasting improvements in patients' sense of well-being,
reduce fatigue, increase appetite and work capacity, and improve exercise
tolerance, libido and work performance. Further studies are needed to
demonstrate whether greater haemoglobin concentrations are associated with
greater improvements in quality of life during epoetin treatment.
Keywords: epoetin; haemoglobin; left ventricular
hypertrophy; morbidity; mortality; quality of life
ORIGINAL ARTICLES
Chairman's workshop report. What are The short-term and long-term consequences of anaemia in CRF patients?
Department of Nephrology VI Medizinische Abteilung, Klinikum Schwabing, Kolner Platz 1, 80804 Munich, Germany
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  P. C. Lee, A. S. Kini, C. Ahsan, E. Fisher, and S. K. Sharma Anemia is an independent predictor of mortality after percutaneous coronary intervention J. Am. Coll. Cardiol., August 4, 2004; 44(3): 541 - 546. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. S. Silverberg, D. Wexler, and A. Iaina The importance of anemia and its correction in the management of severe congestive heart failure Eur J Heart Fail, December 1, 2002; 4(6): 681 - 686. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Stoves, H. Inglis, and C. G. Newstead A randomized study of oral vs intravenous iron supplementation in patients with progressive renal insufficiency treated with erythropoietin Nephrol. Dial. Transplant., May 1, 2001; 16(5): 967 - 974. [Abstract] [Full Text] [PDF]
|
|