The Role of Endothelin and Prostacyclin on Recombinant Erythropoietin-a Induced Hypertension in Hemodialysis Patients

OBJECTIVE: Recombinant human erythropoietin (r-HuEPO) was found to be associated with increased blood pressure in hemodialysis (HD) patients. Plasma endothelin-1(ET-1) was reported to be increased during treatment with r-huEPO in HD patients. Prostacyclin (PGI2) was found to be associated with the reduction in vascular resistance. We aimed to determine the role of ET-1 and PGI2 on r-huEPO-induced hypertension in HD patients. MATERIAL and METHODS: 43 HD patients (19 females, 24 males) were randomly assigned to groups. Group 1 (n= 15) consisted of patients receiving r-HuEPO-a subcutaneously after each dialysis session for 6 to 42 months. Group 2 (n= 15, control group) consisted of patients who did not receive any r-huEPO and group 3 (n= 13) consisted of patients who received r-huEPO-a subcutaneously after each dialysis session for 12 weeks. Plasma ET-1,2 and 6-keto-PGF1-a were measured. RESULTS : There were no differences in terms of ET-1,2 and 6-keto-PGF1-a, systolic and diastolic BP and hematocrit levels in group 1 and group 2 patients. However, in group 3 patients, hematocrit, plasma ET1,2 and 6-keto PGF1-a levels were significantly elevated after 12 weeks of rHuEPO treatment. CONCLUSION: We showed that ET-1.2 and 6-keto-PGF1-a levels were found to be significantly increased with 12 weeks of rHu-EPO therapy in HD patients.