RESUMEN
Numerous uremic patients on hemodialysis have pulmonary hypertension attributable to the presence of arteriovenous fistulas, vascular calcification, and endothelial dysfunction due to alterations in the balance between vasoconstrictive and vasodilatory substances. For these reasons, the effects of recombinant human erythropoietin, a drug widely used in patients on dialysis, on the pulmonary circulation were studied. Some authors maintain that recombinant human erythropoietin has an antihypertensive effect, while others have observed that this hormone induces a reduction in pulmonary arterial pressure due to its vasoactive and stimulatory effects on endothelial and smooth muscle cell precursors.
Asunto(s)
Eritropoyetina/uso terapéutico , Hipertensión Pulmonar/tratamiento farmacológico , Animales , Antihipertensivos/farmacología , Antihipertensivos/uso terapéutico , Eritropoyetina/farmacología , Humanos , Hipertensión Pulmonar/etiología , Hipertensión Pulmonar/fisiopatología , Circulación Pulmonar/efectos de los fármacos , Circulación Pulmonar/fisiología , Proteínas Recombinantes , Diálisis Renal/efectos adversosRESUMEN
Patients with end-stage renal disease treated by hemodialysis are exposed to continuous pulmonary insults of multifactorial origin. Alterations in respiratory drive, mechanics, muscle function and gas exchange are frequent in hemodialysis patients. Pulmonary dysfunction may be the direct consequence of circulating uraemic toxins or may result indirectly from volume overload, anaemia, immune suppression, extraosseous calcification, malnutrition, electrolyte disorders, and/or acid-base imbalances. We have emphasised how derangement of diffusing capacity represents the most frequent and important respiratory abnormality in haemodialysed patients. It has been postulated that some forms of selective damage in the alveolo-capillary wall interferes with alveolar gas exchange.