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Nephrol Dial Transplant (1989) 4: 1065-1069
© 1989 European Renal Association-European Dialysis and Transplant Association

research-article

Seizures in Haemodialysis Patients Treated with Recombinant Human Erythropoietin

M. E. Edmunds1,, J. Walls1, B. Tucker2, L. R. I. Baker2, C. R. V. Tomson3, M. Ward3, J. Cunningham4, R. Moore4 and C. G. Winearls5

1Leicester General Hospital Leicester 2St Bartholomew's Hospital London 3Royal Victoria Infirmary Newcastle upon Tyne 4The London Hospital London 5Churchill Hospital Oxford

Correspondence and offprint requests to: Correspondence and offprint requests to: M. E. Edmunds, Department of Nephrology, Leicester General Hospital, Gwendolen Road, Leicester, UK

Administration of recombinant erythropoietin (r-HuEPO) is an effective treatment for the anaemia of chronic renal failure, but in some patients it has been accompanied by elevated blood pressure. This study focuses on seven patients with end-stage renal failure, managed on haemodialysis, who developed probable hypertensive encephalopathy with seizures during treatment with r-HuEPO. All made a full recovery. The events were not clearly related to the haemoglobin concentrations achieved, and four patients have subsequently been restarted on r-HuEPO therapy at a reduced dose, resulting in a slower increase in haemoglobin with no recurrence of episodes of severe hypertension. Close attention needs to be paid to blood pressure in patients commencing erythropoietin therapy, and it seems prudent to aim for a gradual increase in haemoglobin concentration to allow the circulation to adapt to changes in oxygen delivery and haematocrit.

Keywords: Hypertension; Recombinant human erythropoietin; Seizures


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