Simon P
Service de néphrologie, centre hospitalier La Beauchée, Saint-Brieuc, France.
Rev Med Interne. 1995;16(6):457-61. doi: 10.1016/0248-8663(96)80739-9.
The induction or the aggravation of a hypertension is a side effect of recombinant human erythropoietin therapy in 30% of dialysed patients. Clinical manifestations can be severe. Pathogenesis of erythropoietin-induced hypertension is ill known. Peripheral vascular changes were found in most studies. Recently, it was demonstrated that erythropoietin increased endothelin-1 release by endothelial cells. Ambulatory blood pressure recording seems to be the best method for evaluating the modification of blood pressure profile during the interdialytic period. Erythropoietin-induced hypertension is easily controlled by drugs, but also by low dose of erythropoietin. Subcutaneous administration of erythropoietin is an approach to avoid the induction of hypertension. Furthermore economical advantages of subcutaneous administration are proven.
在30%的透析患者中，重组人促红细胞生成素治疗的副作用是引发或加重高血压。临床表现可能很严重。促红细胞生成素诱导的高血压的发病机制尚不清楚。大多数研究发现外周血管有变化。最近，有研究表明促红细胞生成素会增加内皮细胞释放内皮素-1。动态血压记录似乎是评估透析间期血压变化情况的最佳方法。促红细胞生成素诱导的高血压很容易通过药物控制，低剂量的促红细胞生成素也有同样效果。皮下注射促红细胞生成素是一种避免引发高血压的方法。此外，皮下注射的经济优势也已得到证实。
