| Theme | Blood Pressure Control in Chronic Renal Failure | |
|---|---|---|
| Title | Hypertensinogenic effect of EPO | |
| Publish Date | 1997/09 | |
| Author | Satoru Kuriyama | Divison of Nephrology, Saiseikai Central Hospital |
| [ Summary ] | EPO-induced hypertension can be seen specifically in patients with chronic renal failure. The incidence of EPO-induced hypertension has been estimated to be approximately 30% in HD patients and 20% or less in CAPD and predialysis patients. The mechanisms by which EPO exerts this hypertensinogenic effect may be multifactorial;loss of hypoxic vasodilation, increased blood viscocity, direct vascular effect, effects via the endothelium, increased plasma catecholamines and augmented appetite. EPO-induced hypertension can be prevented with well-controlled blood pressure, gentlly lowering the rate of Ht improvement, and perhaps the use of antiplatelet agents. The treatment should be performed by carefully adjusting dry weight and appropriate antihypertensive agents. The first therapeutic choice must be Ca-antagonists or ACE inhibitors. The latter should not be used for patients with a serum Cr exceeding 2mg/dl. In order to avoid abrupt deterioration of renal function, blood pressure should be lowered in a gentle and slow manner. |
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