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Gestörte alpha2-Adrenozeptorfunktion bei Hämodialysepatienten mit renaler Anämie — eine mögliche Ursache der Blutdrucksteigerung unter rekombinantem humanem Erythropoietin?

Disturbed function of alpha2-adrenoceptors in renal anemia — A possible reason for increase in blood pressure after recombinant human erythropoietin?

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Summary

Nine patients on maintenance hemodialysis and transfusion-demanding renal anemia (group A) were treated with rHuEPO 120 IU/kg i.v. three times per week. Hemoglobin-content was raised from 7.2±0.9 to 10.4±0.8 g/dl. In all patients blood pressure rose, three patients developed arterial hypertension. Mean diastoloic blood pressure was 66±12 and 78±16 mmHg (p<0.001) before and after rHuEPO. Rise in blood pressure was accompanied by a significant fall in plasma-noradrenaline-levels (from 498±100 to 383±75 pg/ml;p<0.05) and alpha2-adrenoceptor-density (from 574±76 to 384±49;p<0.05). Compared to nine patients on maintenance hemodialysis and hematocrit over 30% (group B), patients with severe renal anemia (group A before treatment) had higher densities of alpha2-adrenoceptors (574±76 vs. 218±32;p<0.001) despite higher plasma-noradrenaline-levels (498±100 vs. 399±63; n.s.). We suppose a anemia-related disturbance of alpha2-receptor-function with the result of abolished receptor down-regulation and impaired vascular reagibility to vasoconstricting stimuli. With the correction of anemia receptor-function improves, receptor down-regulation as well as vascular reagibility is re-established resulting in augmented vascular resistance and higher blood pressure.

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Abbreviations

rHuEPO:

rekombinantes humanes Erythropoietin

teMAP:

mittlerer arterieller Blutdruck

RR:

Blutdrucknach RIVA-ROCCI

RBF:

regionaler Blutfluß

RPR:

regionaler peripherer Widerstand

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Authors and Affiliations

  1. Medizinische Klinik II, Deutschland

    R. Müller, H. M. Steffen & W. Kaufmann

  2. Augenklinik, Deutschland

    R. Brunner

  3. Medizinische Klinik I der Universität Köln, Deutschland

    M. Pollok & C. A. Baldamus

Authors
  1. R. Müller
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  2. H. M. Steffen
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  3. R. Brunner
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  4. M. Pollok
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  5. C. A. Baldamus
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  6. W. Kaufmann
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Müller, R., Steffen, H.M., Brunner, R. et al. Gestörte alpha2-Adrenozeptorfunktion bei Hämodialysepatienten mit renaler Anämie — eine mögliche Ursache der Blutdrucksteigerung unter rekombinantem humanem Erythropoietin?. Klin Wochenschr 69, 742–748 (1991). https://doi.org/10.1007/BF01797612

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  • DOI: https://doi.org/10.1007/BF01797612

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