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Review: Relationship between Erythropoietin Administration and Alterations of Renin-Angiotensin-Aldosterone

Division of Nephrology and Hypertension, Cleveland Clinic Florida, Weston, Florida, USA, Division of Nephrology, University of Miami School of Medicine, Miami, Florida, USA

Murray Epstein

Division of Nephrology and Hypertension, Cleveland Clinic Florida, Weston, Florida, USA, murraye{at}gate.net, Division of Nephrology, University of Miami School of Medicine, Miami, Florida, USA

The effect of erythropoietin (EPO) administration on the responsiveness of the renin-angiotensin-aldosterone system (RAAS) has not been established. Because patients with chronic kidney disease (CKD) require EPO for their management as CKD progresses, it is important to ascertain whether EPO treatment alters the RAAS. If EPO administration stimulates renin-angiotensin or aldosterone (ALDO) this intervention would mediate cardiovascular and renal injury, and consequently promote cardiovascular events and/or exacerbate the progression of renal disease.We reviewed the available publications investigating the effects of EPO on the RAAS. In CKD patients following EPO administration plasma renin activity (PRA) was unchanged in all three and ALDO was not altered in the two studies in which it was determined. In end-stage renal disease (ESRD) patients undergoing dialysis following EPO administration, four studies reported a decrease in PRA levels whereas the remaining nine disclosed no change in PRA levels.The changes in ALDO levels after EPO administration in ESRD patients were discrepant with two studies reporting an increase, two reporting a decrease and the remaining three disclosing no change.

Key Words: Erythropoietin • Renin-angiotensin • Aldosterone • Chronic kidney disease • End-stage renal disease

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Journal of Renin-Angiotensin-Aldosterone System, Vol. 7, No. 3, 135-138 (2006)
DOI: 10.3317/jraas.2006.022


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This Article Abstract Free Full Text (Free PDF) Free Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Rosario, R. Articles by Epstein, M. Search for Related Content PubMed PubMed Citation Articles by Rosario, R. Articles by Epstein, M. Pubmed/NCBI databases Substance via MeSH Social Bookmarking                         What's this?