Epoetin alfa's effect on left ventricular hypertrophy and subsequent mortality

Jones, Michael; Just, Julie

doi:10.1016/j.ijcard.2004.08.051

Cited by 15 publications

(10 citation statements)

References 50 publications

(118 reference statements)

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“…In a recent meta-analysis of 95 papers and abstracts of EPO therapy in CKD and ESKD, it was concluded that EPO therapy resulted in a reduction in left ventricular hypertrophy (LVH) parameters and in a reduction of end systolic and diastolic volumes along with an increase in the left ventricular ejection fraction (LVEF). The regression in LVH was associated with a lower incidence of cardiovascular-related morbidity and mortality, hospitalization rate, hospital length of stay, and number of blood transfusions as well as an improvement in QoL [24].…”

Section: Chf Ckd and Anemiamentioning

confidence: 88%

“…Up to now it is acceptable to increase the Hb in CKD and ESKD up to 12 g/dl [24,55]. A recent uncontrolled study in hemodialysis patients found that complete correction of anemia to 13.5-14.5 g/dl along with aggressive therapy with all the above cardioprotecive agents and excellent blood pressure control was associated with an extremely low mortality over a mean of 3.4 years [145], despite the fact that 90.6% had symptomatic CHF when first seen (NYHA II-IV).…”

Section: Antioxidant Effects Of Epomentioning

confidence: 99%

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Anemia, chronic renal disease and congestive heart failure—the cardio renal anemia syndrome: the need for cooperation between cardiologists and nephrologists

Silverberg¹,

Wexler²,

Iaina³

et al. 2006

Int Urol Nephrol

105

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Many patients with congestive heart failure (CHF) fail to respond to maximal CHF therapy and progress to end stage CHF with many hospitalizations, poor quality of life (QoL), progressive chronic kidney disease (CKD) which can lead to end stage kidney disease (ESKD), or die of cardiovascular complications within a short time. One factor that has generally been ignored in many of these people is the fact that they are often anemic. The anemia in CHF is due mainly to the frequently-associated CKD but also to the inhibitory effects of cytokines on erythropoietin production and on bone marrow activity, as well as to their interference with iron absorption from the gut and their inhibiting effect on the release of iron from iron stores. Anemia itself may further worsen cardiac and renal function and make the patients resistant to standard CHF therapy. Indeed anemia in CHF has been associated with increased severity of CHF, increased hospitalization, worse cardiac function and functional class, the need for higher doses of diuretics, progressive worsening of renal function and reduced QoL. In both controlled and uncontrolled studies of CHF, the correction of the anemia with erythropoietin (EPO) and oral or intravenous (IV) iron has been associated with improvement in many cardiac and renal parameters and an increased QoL. EPO itself may also play a direct role in improving the heart unrelated to the improvement of the anemia--by reducing apoptosis of cardiac and endothelial cells, increasing the number of endothelial progenitor cells, and improving endothelial cell function and neovascularization of the heart. Anemia may also play a role in the worsening of acute myocardial infarction and chronic coronary heart disease (CHD) and in the cardiovascular complications of renal transplantation. Anemia, CHF and CKD interact as a vicious circle so as to cause or worsen each other- the so-called cardio renal anemia syndrome. Only adequate treatment of all three conditions can prevent the CHF and CKD from progressing.

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Section: Chf Ckd and Anemiamentioning

confidence: 88%

Section: Antioxidant Effects Of Epomentioning

confidence: 99%

Anemia, chronic renal disease and congestive heart failure—the cardio renal anemia syndrome: the need for cooperation between cardiologists and nephrologists

Silverberg¹,

Wexler²,

Iaina³

et al. 2006

Int Urol Nephrol

105

View full text Add to dashboard Cite

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“…The majority of studies indicate that erythropoietin therapy results in anemia amelioration and LVH reduction. 20 But Levin et al 21 recently conducted a clinical trial of 147 patients with mild-to-moderate CKD who were randomly assigned to a treatment group receiving erythropoietin to maintain or achieve hemoglobin level targets of 12 to 14 g/dL and to a control/delayed treatment group with hemoglobin levels of 9 Ϯ 0.5 g/dL and target level of 9 to 10.5 g/dL. In their study, there was no statistically significant difference between groups for mean change in LVM index from baseline to 24 months.…”

Section: Discussionmentioning

confidence: 99%

Progression of left ventricular hypertrophy in children with early chronic kidney disease: 2-year follow-up study

Mitsnefes¹,

Kimball²,

Kartal³

et al. 2006

The Journal of Pediatrics

126

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“…Subsequently, several observational studies have demonstrated associations between anemia and harder outcomes, such as mortality and cardiovascular complications (4 -6). Likewise, studies have documented an association between the severity of anemia and left ventricular hypertrophy (LVH) (7,8). By the early to mid-1990s, the majority of dialysis and non-dialysis CKD patients and many patients without CKD were receiving epoetin therapy.…”

mentioning

confidence: 99%

Anemia of Chronic Kidney Disease

Singh¹

2008

Clinical Journal of the American Society of Nephrology

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Epoetin alfa's effect on left ventricular hypertrophy and subsequent mortality

Cited by 15 publications

References 50 publications

Anemia, chronic renal disease and congestive heart failure—the cardio renal anemia syndrome: the need for cooperation between cardiologists and nephrologists

Anemia, chronic renal disease and congestive heart failure—the cardio renal anemia syndrome: the need for cooperation between cardiologists and nephrologists

Progression of left ventricular hypertrophy in children with early chronic kidney disease: 2-year follow-up study

Anemia of Chronic Kidney Disease

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