Key result
Erythropoietin therapy in patients with cardiorenal syndrome improved baseline hemoglobin levels and decreased myocardial remodeling, but did not reduce cardiovascular mortality.
Why the study?
To evaluate the use of erythropoietin in patients with cardiorenal syndrome and its effects on hemoglobin, major cardiovascular events, and hospitalization rates.
Does erythropoietin therapy improve hemoglobin, cardiovascular events, and hospitalization rates in patients with cardiorenal syndrome?
Systematic Review
Does erythropoietin therapy improve hemoglobin, cardiovascular events, and hospitalization rates in patients with cardiorenal syndrome?
Erythropoietin therapy in cardiorenal syndrome improves hemoglobin and cardiac remodeling but does not reduce cardiovascular mortality.
EPO may improve Hb and reduce major CV events in CRS; extends limited evidence but leaves effects on mortality and hospitalization open for RCTs.
BACKGROUND: Heart and kidney dysfunction frequently coexist in patients with acute heart failure due to the overlap between these two organ systems. Cardiorenal syndrome (CRS) results from pathology occurring in the heart and kidneys along with the consequences of dysfunction in one organ contributing to dysfunction in the other and vice versa. AIM: To evaluate the use of erythropoietin (EPO) in patients with CRS and its effects on hemoglobin (Hb), major cardiovascular (CV) events, and hospitalization rates. METHODS: On February 24, 2022, searches were conducted using PubMed, MEDLINE, and EMBASE, and 148 articles were identified. A total of nine studies were considered in this systematic review. We assessed the included articles based on the National Heart, Lung, and Blood Institute quality assessment tools for controlled intervention and observational cohort or cross-sectional studies. An assessment of bias risk was conducted on the chosen studies, and data relevant to our review was extracted. RESULTS: The systematic review of these studies concluded that most existing literature indicates that EPO improves baseline Hb levels and decreases myocardial remodeling and left ventricular dysfunction without reducing CV mortality. In addition, the effect of EPO on the hospitalization rate of patients with CRS needs to be further studied since this relationship is unknown. Future studies, such as randomized controlled clinical trials and prospective cohort studies, should be conducted to enhance the literature on the potential of EPO therapy in patients with CRS. CONCLUSION: Our systematic review suggests that EPO therapy may have a significant role in managing CRS. The review highlights the potential benefits of EPO in improving baseline Hb levels, reducing the risk of major CV events, improving cardiac remodeling, myocardial function, New York Heart Association class, and B-type natriuretic peptide levels. However, the effect of EPO treatment on hospitalization remains unclear and needs further exploration.
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Bhangal et al. (2023) conducted a systematic review in Cardiorenal syndrome. Erythropoietin (EPO) was evaluated on Hemoglobin, major cardiovascular events, and hospitalization rates. Erythropoietin therapy in patients with cardiorenal syndrome improved baseline hemoglobin levels and decreased myocardial remodeling, but did not reduce cardiovascular mortality.
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