Abstract

This prospective study was designed to examine the intradialytic cardiovascular function in rHuEPO treated uraemic children: EPO group in comparison to non-receiving rHuEPO subjects: noEPO group. Non-invasive, continuous haemodynamic monitoring using an impedance cardiography method was done during 30 acetate HD-sessions. The following parameters were evaluated: mean arterial pressure (MAP), systemic vascular resistance index (SVRI), stroke index (SI), heart rate (HR), ejection fraction (EF), thoracic fluid conductivity (TFC) and index of contractility (IC). Both in the EPO and noEPO groups a significant SI and IC increase was noted during HD with a simultaneous EF improvement only in the EPO group. This underlines a better compliance and myocardial performance in children treated with rHuEPO. During acetate haemodialysis a greater SVRI decline was observed in the EPO group than in noEPO group. This may due to changed vascular reactivity resulting from anaemia correction in children on rHuEPO treatment. Our study confirms the MAP decrease in the EPO group as the result of higher thoracic fluids reduction and more significant decline in SVRI as compared to those in the noEPO group. However, in the EPO group haemodynamic stability during HD was maintained despite the MAP drop. In the EPO a group significantly higher HR acceleration was observed comparing in contrast to that in the noEPO group.

Keywords: haemodialysis, children, Erythropoietin, impedance cardiography, haemodynamic changes