High-dose intravenous epoetin does not increase blood pressure in critically ill patients with acute kidney injury

Treatment of renal anemia with erythropoietic stimulating agents sometimes increases blood pressure. It is uncertain whether this is due to direct vasoconstriction and/or increased red blood cell mass. We conducted a post-hoc analysis of 160 critically ill patients in the EARLYARF trial with elevat...

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Main Author:	Md Ralib, Azrina
Format:	Article
Language:	English
Published:	Dustri-Verlag 2013
Subjects:	R Medicine (General)
Online Access:	http://irep.iium.edu.my/10623/ http://irep.iium.edu.my/10623/ http://irep.iium.edu.my/10623/1/1._Clinical_Nephrology_2013_EPO_%26_BP.pdf

id	iium-10623
recordtype	eprints
spelling	iium-106232014-03-04T08:11:17Z http://irep.iium.edu.my/10623/ High-dose intravenous epoetin does not increase blood pressure in critically ill patients with acute kidney injury Md Ralib, Azrina R Medicine (General) Treatment of renal anemia with erythropoietic stimulating agents sometimes increases blood pressure. It is uncertain whether this is due to direct vasoconstriction and/or increased red blood cell mass. We conducted a post-hoc analysis of 160 critically ill patients in the EARLYARF trial with elevated urinary γ-glutamyltranspeptidase and alkaline phosphatase, indicating acute kidney injury. Patients received two doses of intravenous epoetin (500 U/kg), 24 hours apart, or placebo, in a randomized, double-blind study design. Hourly mean arterial pressure (MAP), and norepinephrine equivalent dose (NED: determined using equipotency conversion factors for doses of epinephrine, vasopressin, phenlyephrine, or dopamine) were extracted from clinical records. The differences between baseline and maximum MAP and NED (∆MAP and ∆NED) over 4, 24, 72-hour, and 30-day periods following study drug administration were compared between groups. At baseline, MAP was 78±14 mmHg in the epoetin group and 81±15 mmHg in the placebo group (p=0.22). There were no differences between groups in ∆MAP (6±14 versus 7±14 mmHg; p=0.53), in ∆NED, or in ∆MAP adjusted for ∆NED at 4 hours, or at any time points. A subgroup analysis of only those patients not requiring vasopressor support (n=71) also showed no differences between epoetin and placebo for all outcomes. We concluded that intravenous high dose epoetin does not acutely increase blood pressure, suggesting no acute vasoconstrictor effect in this setting. Dustri-Verlag 2013-01-15 Article PeerReviewed application/pdf en http://irep.iium.edu.my/10623/1/1._Clinical_Nephrology_2013_EPO_%26_BP.pdf Md Ralib, Azrina (2013) High-dose intravenous epoetin does not increase blood pressure in critically ill patients with acute kidney injury. Clinical Nephrology, 79 (5). pp. 370-379. ISSN 0301-0430 http://www.dustri.com/nc/journals-in-english/mag/clinical-nephrology/vol/volume-79.html
repository_type	Digital Repository
institution_category	Local University
institution	International Islamic University Malaysia
building	IIUM Repository
collection	Online Access
language	English
topic	R Medicine (General)
spellingShingle	R Medicine (General) Md Ralib, Azrina High-dose intravenous epoetin does not increase blood pressure in critically ill patients with acute kidney injury
description	Treatment of renal anemia with erythropoietic stimulating agents sometimes increases blood pressure. It is uncertain whether this is due to direct vasoconstriction and/or increased red blood cell mass. We conducted a post-hoc analysis of 160 critically ill patients in the EARLYARF trial with elevated urinary γ-glutamyltranspeptidase and alkaline phosphatase, indicating acute kidney injury. Patients received two doses of intravenous epoetin (500 U/kg), 24 hours apart, or placebo, in a randomized, double-blind study design. Hourly mean arterial pressure (MAP), and norepinephrine equivalent dose (NED: determined using equipotency conversion factors for doses of epinephrine, vasopressin, phenlyephrine, or dopamine) were extracted from clinical records. The differences between baseline and maximum MAP and NED (∆MAP and ∆NED) over 4, 24, 72-hour, and 30-day periods following study drug administration were compared between groups. At baseline, MAP was 78±14 mmHg in the epoetin group and 81±15 mmHg in the placebo group (p=0.22). There were no differences between groups in ∆MAP (6±14 versus 7±14 mmHg; p=0.53), in ∆NED, or in ∆MAP adjusted for ∆NED at 4 hours, or at any time points. A subgroup analysis of only those patients not requiring vasopressor support (n=71) also showed no differences between epoetin and placebo for all outcomes. We concluded that intravenous high dose epoetin does not acutely increase blood pressure, suggesting no acute vasoconstrictor effect in this setting.
format	Article
author	Md Ralib, Azrina
author_facet	Md Ralib, Azrina
author_sort	Md Ralib, Azrina
title	High-dose intravenous epoetin does not increase blood pressure in critically ill patients with acute kidney injury
title_short	High-dose intravenous epoetin does not increase blood pressure in critically ill patients with acute kidney injury
title_full	High-dose intravenous epoetin does not increase blood pressure in critically ill patients with acute kidney injury
title_fullStr	High-dose intravenous epoetin does not increase blood pressure in critically ill patients with acute kidney injury
title_full_unstemmed	High-dose intravenous epoetin does not increase blood pressure in critically ill patients with acute kidney injury
title_sort	high-dose intravenous epoetin does not increase blood pressure in critically ill patients with acute kidney injury
publisher	Dustri-Verlag
publishDate	2013
url	http://irep.iium.edu.my/10623/ http://irep.iium.edu.my/10623/ http://irep.iium.edu.my/10623/1/1._Clinical_Nephrology_2013_EPO_%26_BP.pdf
first_indexed	2023-09-18T20:20:01Z
last_indexed	2023-09-18T20:20:01Z
_version_	1777408044137709568

High-dose intravenous epoetin does not increase blood pressure in critically ill patients with acute kidney injury

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