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Recombinant human erythropoietin (rhu EPO) is the choice treatment of dialytic anemia; however, this therapy has side effects due to the increased number of blood components involved. It seemed to us worth assessing, by hemorheological study, the impact of such a treatment on blood flow properties, already impaired in this type of patients. This study was designed to measure the evolution of hemorheological parameters in 16 hemodialysed patients before and after 2.3 and 6 months of treatment with rhu EPO. Hemorheological work-ups included: erythrocyte filtration with a hemorheometer; blood and plasma viscosities (LS30), ATP and 2.3 DPG, RBC aggregation (Sefam erythroaggregameter), RBC morphology under a scanning electron microscope; blood counts and full biochemical work-ups were performed to explore renal function. The results showed, besides a significant increase in hemoglobin: normalized rigidity index, reflecting the better deformability of erythrocytes; a moderate increase in blood viscosity with uncorrected hematocrit, becoming significant after 6 months of treatment. This increase however did not reach the values that could be expected with the increased hematocrit (it was probably balanced by improved erythrocyte deformability, which is confirmed by the fact that with corrected hematocrit, blood viscosity decreases during treatment). Studying erythrocyte aggregation in hemodialysed patients reveals, in the absence of any treatment, a decrease in aggregation time and a higher dissociation threshold, which reflects a tendency to erythrocyte hyperaggregation enhanced by erythropoietin.(ABSTRACT TRUNCATED AT 250 WORDS)

Hemorheological parameters were studied in 218 subjects: 129 alcoholic liver diseases, 19 alcoholic patients without liver damage, 20 liver diseases without alcoholism and 50 controls. Whole blood filtration (WBF) is significantly decreased in the group of alcoholic patients; whole blood and plasma viscosity are increased in the groups of alcoholic patients as well as in the group of non alcoholic liver diseases. The liver damage seems not to be a determining factor to the genesis of filterability impairment. Alcohol and/or one of its metabolites induce erythrocytes morphological alterations (scanning electro-microscopy) correlated with some alterations of the RBC membrane lipids content (increased cholesterol/phospholipids ratio). It is suggested that these hemorheological patterns must be discussed in cases of alcoholic liver diseases as well as in following up alcohol withdrawal.