International Heart Journal
Online ISSN : 1349-3299
Print ISSN : 1349-2365
ISSN-L : 1349-2365
Clinical Studies
Effects of Anemia Correction by Erythropoiesis-Stimulating Agents on Cardiovascular Function in Non-Dialysis Patients With Chronic Kidney Disease
Makoto SuzukiYoshiyuki HadaMakoto AkaishiMichiaki HiroeKazutaka AonumaYoshiharu TsubakiharaTadao Akizawa
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2012 Volume 53 Issue 4 Pages 238-243

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Abstract

Anemia is a significant risk factor for patients with chronic kidney disease (CKD). Here, we investigated the effects of anemia correction on cardiac functions in CKD patients. Pre-dialysis CKD patients (n = 171) without known risk factors for cardiovascular disease (CVD) other than CKD with hemoglobin (Hb) concentrations < 10.0 g/dL were enrolled for evaluation of cardiac functions and biomarkers before and after the 16-week treatment of erythropoiesis-stimulating agents. The treatment significantly increased Hb concentrations in all patients who completed the study (n = 143, 8.91 ± 0.87 versus 11.27 ± 1.31 g/dL; n < 0.001) and among patients whose echocardiograms were available for evaluation (n = 77, 8.92 ± 0.94 versus 11.24 ± 1.13 g/dL; P < 0.001). The left ventricular mass index (LVMI) was decreased (121.3 ± 25.8 versus 114.7 ± 25.1 g/m2, n = 77, P = 0.012) and significant correlation between the change in the LVMI and Hb concentration was noted (P = 0.011). The levels of B-type natriuretic peptide and human atrial natriuretic peptide, and the cardio-thoracic ratio were significantly increased among subjects with Hb concentrations < 11.0 g/dL at completion of the study. The changes in these parameters were significantly correlated with the Hb concentrations (P = 0.033, P = 0.011, and P < 0.001, respectively). No significant differences were observed in the electrocardiographic parameters. Correcting Hb levels higher than those conventionally recommended reduced left ventricular hypertrophy and myocardial stress, lowering risks for CVD in pre-dialysis CKD patients.

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© 2012 by the International Heart Journal Association
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