Improvement Of Left Ventricular Hypertrophy By Anemic-correcting Erythropoietin Therapy In Chronic Renal Insufficiency

Objective:Left ventricular hypertrophy(LVH) is an independent risk factor for morbidity and mortality in dialysis patients.It remains unclear whether efforts to correct anemia in patients with mild-to-moderate chronic renal insufficiency(CRI) can reverse LVH.We investigated left-ventricular mass index(LVMI) evolution in anemic CRI patients with or without recombinant human erythropoietin(rHuEPO) therapy.Methods: 76 patients with chronic renal diseaseⅡtoⅢstage,GFR15to59,40 of pations whom with hemoglobin(Hb) levels 80g/L≤(Hb)＜110g/Lreceived rHuEPO(Groupl),36patients with comparable Hb levels(80g/L≤Hb<110g/L) but did not receiver HuEPO (Group2)controls.Echocardiographic studies were performed to evaluate LVMI at baseline and every 3 months during six month period.Results:At baseline,the prevalence of LVH was 42.1%in Group 1,39.8%in Group 2,LVMI was inversely correlated with Hb levels(r=-0.59,P＜0.001).There was no difference in age,gender,aetiology of renal failure,blood pressure(BP) and cardiovascular risk factors between the 2groups.The administration of rHuEPO in Groupl significantly increased Hb levels from 97.89±12.87g/L to 118.8±12.93g/L and LVMI significantly reduced from 164.0±24.5 g/ m~2 to 132.6±27.8g/m~2.The prevalence of LVH decreased 21.7%after a partial correction of anemia at 6months,whereas Hb levels in control stended to decrease and LVMI significantly increased compared with baseline.The prevalence of LVH was significantly increased 29.1%(P＜0.05).Hb significantly reduced from97.59±19.13g/L to 83.89±13.94g/L,LVMI significantly increased from 158.4±26..9g/m~2to186.4±28.3g/ m~2,LVH(P＜0.05)o in Group 2 after 6months.Conclusion:High prevalence of LVH was present in pre-dialysis CRI patients,which is associated with severity of anemia.Early treatment of anemia with rHuEPO can reverse LVH in CRI patients.