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Effect of hemodialysis and recombinant human erythropoietin on determinants of blood viscosity.

Blood viscosity (hemorheology) is a major determinant of the rate of blood flow, and increases in viscosity are known to be involved in the etiology of vascular diseases. This placebo-controlled study investigated the independent and combined effects of hemodialysis and recombinant human erythropoietin (rHuEpo) on determinants of blood viscosity in patients with chronic renal failure and related any changes to the normal physiological range. Hemodialysis patients were shown to have a high incidence of rheological abnormalities although the degree of anemia associated with chronic renal failure compensated for these changes. The main effect of both hemodialysis and rHuEPO treatment was an increase in hematocrit associated with a rise in blood viscosity and inconsistent changes in red blood cell (RBC) deformability. The rise in viscosity was significant only following rHuEPO treatment. Hemodialysis-induced increases in blood and plasma viscosity correlated strongly with the degree of hemoconcentration. Although hemodialysis patients have inherent hemorheological abnormalities, correction of renal anemia with rHuEPO to a hematocrit level of < 0.35 in conjunction with dialysis-induced hemoconcentration did not result in adversely high blood viscosity levels in any patient.