Schaefer R M, Leschke M, Strauer B E, Heidland A
Department of Internal Medicine, University of Würzburg, FRG.
Am J Nephrol. 1988;8(6):449-53. doi: 10.1159/000167652.
Fifteen hemodialysis patients suffering from stable anemia were treated with recombinant human erythropoietin (r-HuEPO). Within 16 weeks, hematocrit values increased from 23.7 +/- 1.2 to 35.7 +/- 0.2%. Simultaneously, mean predialytic blood pressure rose significantly from 131/79 to 139/85 mm Hg. Three out of 15 patients developed frank hypertension and had to be put on antihypertensive therapy. When the hematocrit was lowered again from 36.3 +/- 1.8 to 30.5 +/- 1.2% in these 3 patients, blood pressure was attenuated and the antihypertensive medication could be reduced or abolished. With rising hematocrit values, whole blood viscosity increased at both low (+42%) and high shear rates (+33%) without reaching the values seen in healthy subjects. By contrast, plasma viscosity was already elevated in hemodialysis patients prior to r-HuEPO treatment and showed only a slight, but insignificant increase during r-HuEPO treatment. Since whole blood viscosity is one factor that determines vascular resistance, it is conceivable that the development of hypertension during correction of the renal anemia is, at least partly, due to an increment of blood viscosity.
15名患有稳定型贫血的血液透析患者接受了重组人促红细胞生成素（r-HuEPO）治疗。在16周内，血细胞比容值从23.7±1.2%升至35.7±0.2%。同时，透析前平均血压从131/79毫米汞柱显著升至139/85毫米汞柱。15名患者中有3名出现明显高血压，不得不接受抗高血压治疗。当这3名患者的血细胞比容再次从36.3±1.8%降至30.5±1.2%时，血压降低，抗高血压药物可减量或停用。随着血细胞比容值升高，全血黏度在低剪切率（+42%）和高剪切率（+33%）时均增加，但未达到健康受试者的水平。相比之下，血浆黏度在r-HuEPO治疗前的血液透析患者中就已升高，在r-HuEPO治疗期间仅略有增加，但无统计学意义。由于全血黏度是决定血管阻力的因素之一，可以推测，肾性贫血纠正过程中高血压的发生至少部分归因于血液黏度的增加。
