Introduction. Suboptimal correction of anemia is associated with increased
prevalence of cardiovascular diseases and increased morbidity and mortality
of pre-dialysis and dialysis patients. The aim of the study was to compare
the effect of optimal vs. suboptimal correction of anemia in hemodialysis
patients with left ventricular hypertrophy. Material and Methods. The study
included 50 patients, 32 males and 18 females, their mean age being 49.4?11.8
years, from five hemodialysis centers (Clinical Hospital Center Zvezdara,
Beograd, Clinical Center Novi Sad, hospitals in Krusevac, Pirot and
Zrenjanin). The patients had suboptimal hemoglobin level in spite of therapy
(7.8?3.8 g/dl). In addition, the most important inclusion criteria was the
left ventricular mass index above 160 g/m2 and the primary efficacy parameter
was a decrease in the left ventricular mass index during 12 month study
period. Results. During the study, the number of patients who reached their
hemoglobin >12 g/dl increased and the target hemoglobin (12-13 g/dl) was
achieved in 24 (52%) of patients at the end of the study. At the same time,
the left ventricular mass index significantly decreased as compared with the
initial values (p=0.014). The left ventricular mass index was not
significantly decreased in the patients who did not achieve the target
hemoglobin level (207?65 vs. 217?38 g, p=ns) as compared with the patients
who achieved the target hemoglobin (179?32 g/ m2 vs. 197?38 g/m2, p=0.007).
The left ventricular ejection fraction did not change significantly during
the study period. Conclusion. Anemia correction with erythropoietin ?
resulted in the significantly corrected left ventricular hypertrophy in
hemodialysis patients who had had a suboptimal hemoglobin level. Our results
have shown that correction of left ventricular hypertrophy is possible with
hemoglobin value of 12 g/dl at least.
A Randomized, Controlled Trial of the Effect of Allopurinol on Left Ventricular Mass Index in Hemodialysis Patients
