Improvement of Erythropoietin-Induced Hypertension in Hemodialysis Patients Changing the Administration Route

Abstract

The aim of the present study has been to assess whether the administration of recombinant human erythropoietin (rHuEPO) by the subcutaneous (sc) route improves blood pressure control of dialysis patients with erythropoietin-induced hypertension. We have selected 13 hemodialysis patients who have remained hypertensive after more than one year of i.v. rHuEPO treatment (mean 22 +/- 8 months, range 12-35 months). Hematocrit, rHuEPO dose, predialysis mean arterial pressure and antihypertensive drug dosage had remained constant during the last six months. These patients were switched to sc administration of rHuEPO thrice weekly, with reduction of rHuEPO dose by one third (from 149 +/- 56 to 98 +/- 53 IU/kg/week). Concomitantly, predialysis mean arterial pressure significantly decreased (113.1 +/- 7.8 during the last month of i.v. administration vs 107.8 +/- 9.8 during the first month of sc administration, p < 0.05, and 105.5 +/- 5.2 mmHg at six months, p < 0.05), without relevant changes in hematocrit. After six months of sc administration, 5 patients remained normotensive without drugs and 6 out of the remaining 8 patients required antihypertensive drugs at lower doses. Administration of rHuEPO by sc route decreases dose requirements and improves blood pressure control in hypertensive patients when treated by i.v. route.

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