Endocrine Abstracts

Background: Kidney diseases and cardiac diseases can affect each other. Patient with renal failure have many cardiac problems specially heart failure, anemia of CRF is resistant to treatment with iron or even blood transfusion and erythropoietin therapy gives good results as the failing kidney can not synthesize it

The previous published data showed that EPO treatment in patients with cardiorenal syndrome (CRS) anemia led to reverse ventricular remodeling together with systolic function improvement. These changes were supported by a fall in BNP, its plasma lowering might indirectly signal an improvement in cardiac function and outcome in patients with CRS in whom the anemia is corrected by EPO.

Aim of the work: To investigate the value of erythropoietin therapy in the treatment of CRS patients with anemia and to evaluate the relationship between clinical, echocardiography and serum BNP levels in those patients in comparison with the standard therapy as iron and blood transfusion.

Patients & methods: The prospective study included 30 chronic renal failure patients under dialysis who are presented with anemic heart failure diagnosed according to New York Heart Association (NYHA) classification which was proved by echocardiographic finding (EF-FS). Plasma BNP was measured at the beginning and at the end of the study after three months on erythropoietin therapy. patients were divided into (Group 1) was treated with erythropoietin and (Group 2) was receiving standard treatment (Group 2).

Results: (Group 1) on erythropoietin therapy got significant decrease in BNP level by 33.8%, vs only 17.5% in (Group 2) on traditional therapy like blood transfusion, iron got and significant increase in the EF by 6.2% and FS by 3.6% in Group -1 vs significant decreased EF% by 9.7% and FS by 3.2% in Group -2 patients and the results were statistically significant (P>0.05).