Effects of anemia and uremia and a combination of both on cardiovascular structures.

BACKGROUND Cardiovascular complications are a major cause of morbidity and mortality in chronic renal failure (CRF) patients. Chronic anemia is a complication of CRF and a cardiovascular risk factor per se. It was the aim of the present study to clarify whether uremia and anemia are additive or supra-additive with respect to cardiovascular alterations. METHODS Thirty SD rats were sham operated (sham) or subtotally nephrectomized (SNX). Both groups were subdivided into anemic (target hemoglobin 10 g/dl, by tail artery punctures) and untreated animals. Blood pressure, echocardiographic measurements and morphometric investigations were performed. The study was terminated after 16 weeks. RESULTS Heart rate and blood pressure were similar in all groups. Anemia was comparable in sham+anemia and SNX+anemia. Left ventricular end-diastolic pressure was significantly higher in untreated SNX and SNX+anemia than in sham. Anemia and SNX caused comparable left ventricular hypertrophy (LVH), which was significantly higher in SNX+anemia. In sham animals, anemia induced thickening of intramyocardial arteries, which was significantly more pronounced in SNX with no additional effect of anemia. CONCLUSIONS Experimentally, anemia and CRF induced LVH and intramyocardial arteriolar thickening. If both are combined, the increase in LVH is even more marked, whereas there are no additional effects on intramyocardial structural alterations.