Hematological Problems of Dialysis Patients

  • Joseph W. Eschbach


Recently, there have been numerous significant advances in our knowledge about the pathophysiology and management of the anemia of chronic renal failure. Aluminum, which dialysis patients receive as phosphate binders, can interfere with erythropoiesis (1, 2); significant evidence has been presented to suggest that uremic inhibitors play a minor, if any, role in the causation of the anemia (3, 4); an uremic, anemic sheep model corrected the anemia with infusions of plasma-rich sheep erythropoietin (Epo) and no in vivo nor in vitro erythroid marrow inhibition could be demonstrated (5, 6); and finally, recombinant human erythropoietin (rHuEpo) has been reproduced by recombinant genetic technology methods and has been shown in clinical trials to be effective in eliminating the anemia in almost all hemodialysis patients to which it has been given (7, 8). The measurement of Epo in plasma is now easier and more reliable with the use of radioimmunoassays to either human urinary or recombinant human Epo.


Peritoneal Dialysis Chronic Renal Failure Dialysis Patient Serum Ferritin Hemodialysis Patient 
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  1. 1.
    Kaiser L, Schwartz KA: Aluminum-induced anemia. Am J Kidney Dis 6: 348, 1985PubMedGoogle Scholar
  2. 2.
    Schwartz KA, Dombrouski J, Burnatowska-Hledin M, Mayor G: Microcytic anemia in dialysis patients: Reversible marker of aluminum toxicity. Am J Kidney Dis 9: 217, 1987Google Scholar
  3. 3.
    Eschbach J, Adamson J: Anemia of end-stage renal disease (ESRD). Kidney Int 28: 1, 1985PubMedCrossRefGoogle Scholar
  4. 4.
    Delwiche F, Segal G, Eschbach J, Adamson J: Hematopoietic inhibitors in chronic failure: Lack of in vitro specificity. Kidney Int 29: 641, 1986PubMedCrossRefGoogle Scholar
  5. 5.
    Eschbach J, Mladenovic J, Garcia JF, Wahl PW, Adamson JW: The anemia of chronic renal failure in sheep: Response to erythropoietin-rich plasma in vivo. J Clin Invest 74: 434, 1984PubMedCrossRefGoogle Scholar
  6. 6.
    Mladenovic J, Eschbach JW, Garcia JF, Adamson JW: The anaemia of chronic renal failure in sheep: studies in vitro. Br J Haematol 58: 491, 1984PubMedCrossRefGoogle Scholar
  7. 7.
    Winearls CG, Oliver DO, Pippard MJ, Reid C, Downing MR, Cotes PM: Effect of human erythropoietin derived from recombinant DNA on the anaemia of patients maintained by chronic haemodialysis. Lancet 2: 1175, 1986PubMedCrossRefGoogle Scholar
  8. 8.
    Eschbach JW, Egrie JC, Downing MR, Browne JK, Adamson JW: Correction of the anemia of end-stage renal disease with recombinant human erythropoietin. N Engl J Med 316: 73, 1987PubMedCrossRefGoogle Scholar
  9. 9.
    Aherne WA: The ‘burr’ red cell and azotemia. J Clin Path 10: 252, 1957PubMedCrossRefGoogle Scholar
  10. 10.
    Shaw AB, Scholes MC: Reticulocytosis in renal failure. Lancet 1: 799, 1967PubMedCrossRefGoogle Scholar
  11. 11.
    Caro J, Erslev AJ: Biologic and immunologic erythropoietin in extracts from hypoxic whole rat kidneys and in their tubular and glomerular fractions. J Lab Clin Med 103: 922, 1984PubMedGoogle Scholar
  12. 12.
    Besareb A, Caro J, Erslev A: Eruthropoietin synthesis in the isolated perfused kidneys. Abstracts Int Congr Nephrol 10: 257, 1987Google Scholar
  13. 13.
    Fried W: The liver as a source of extrarenal erythropoietin production. Blood 40: 671, 1973Google Scholar
  14. 14.
    Cotes PM: Immunoreactive erythropoietin in serum. I. Evidence for the validity of the assay method and the physiological relevance of estimates. Br J Haematol 50: 427, 1982PubMedCrossRefGoogle Scholar
  15. 15.
    Garcia JF, Ebbe SN, Hollander L, Cutting HO, Miller ME, Cronkite EP: Radioimmunoassay of erythropoietin: Circulating levels in normal and polycythemic human beings. J Lab Clin Med 99: 624, 1982PubMedGoogle Scholar
  16. 16.
    Van Stone JC, Max P: Effect of erythropoietin on anemia of peritoneally dialyzed anephric rats. Kidney Int 15: 370, 1979PubMedCrossRefGoogle Scholar
  17. 17.
    Anagnostou A, Barone J, Kedo A, Fried W: Effect of erythropoietin therapy on the red cell volume of uremic and non-uremic rats. Br J Haematol 37: 85, 1977PubMedGoogle Scholar
  18. 18.
    Caro J, Erslev AJ: Erythropoiesis and response to erythropoietin in rats with chronic uremia. Blood 50 (Suppl 1): 123, 1979Google Scholar
  19. 19.
    Reissmann KR, Nomura T, Gunn RW, Brosius F: Erythropoietic response to anemia of erythropoietin injection in uremic rats with or without functioning renal tissue. Blood 16: 1411, 1960PubMedGoogle Scholar
  20. 20.
    Mladenovic J, Eschbach JW, Koup JR, Garcia JF, Adamson JW: Erythropoietin kinetics in normal and uremic sheep. J Lab Clin Med 105: 659, 1985PubMedGoogle Scholar
  21. 21.
    Radtke HW, Frei U, Erbes PM, Schoeppe W, Koch KM: Improving anemia by hemodialysis: Effect on serum erythropoietin. Kidney Int 17: 382, 1980PubMedCrossRefGoogle Scholar
  22. 22.
    McGonigle RJS, Husserl F, Wallin JD, Fisher JW: Hemodialysis and continuous ambulatory peritoneal dialysis effects on erythropoiesis in renal failure. Kidney Int 25: 430, 1984PubMedCrossRefGoogle Scholar
  23. 23.
    Caro J, Brown S, Miller O, Murray T, Erslev AJ: Erythropoietin levels in uremic nephric and anephric patients. J Lab Clin Med 93: 449, 1979PubMedGoogle Scholar
  24. 24.
    Callen IR, Limari LR: Blood and bone marrow studies in renal disease. Am J Clin Path 20: 3, 1950PubMedGoogle Scholar
  25. 25.
    Erslev AJ: Humoral regulation of red cell production. Blood 8: 349, 1953PubMedGoogle Scholar
  26. 26.
    Markson JL, Rennie JB: The anemia of chronic renal insufficiency. Scott Med J 1: 320, 1956PubMedGoogle Scholar
  27. 27.
    McDermott FT, Galbraigh AH, Corlett RJ: Inhibition of cell proliferation in renal failure and its significance to the uraemic syndrome: A review. Scot Med J 20: 317, 1975PubMedGoogle Scholar
  28. 28.
    Moriyama J, Saito H, Kinoshita Y: Erythropoietin inhibition in the plasma from patients with chronic renal failure. Haematologia 4: 15, 1970PubMedGoogle Scholar
  29. 29.
    Fisher JW: Mechanism of the anemia of chronic renal failure. Editorial review. Nephron 25: 106, 1980PubMedCrossRefGoogle Scholar
  30. 30.
    Radtke HW, Rege AB, LaMarche MB, Bartos D, Campbell RA, Fisher JW: Identification of spermine as an inhibitor of erythropoiesis in patients with chronic renal failure. J Clin Invest 67: 1623, 1981PubMedCrossRefGoogle Scholar
  31. 31.
    Meytes D, Bogin E, Ma A, Dukes PP, Massry SG: Effects on parathyroid hormone on erythropoiesis. J Clin Invest 67: 1263, 1981PubMedCrossRefGoogle Scholar
  32. 32.
    Freedman MH, Saunders EF, Cattran DC, Rabin EZ: Ribonuelease inhibition of erythropoiesis in anemia of uremia. Am J Kidney Dis 2: 530, 1983PubMedGoogle Scholar
  33. 33.
    Spragg BP, Bentley DP, Coles GA: Anaemia of chronic renal failure. Polyamines are not raised in uraemic serum. Nephron 38: 65, 1984PubMedCrossRefGoogle Scholar
  34. 34.
    Dunn CDR, Trent D: The effect of parathyroid hormone on erythropoiesis in serum-free cultures of fetal mouse liver cells (41108). Proc Soc Exp Biol Med 166: 556, 1981PubMedGoogle Scholar
  35. 35.
    Delwiche F, Garrity MJ, Powel JS, Robertson RP, Adamson JW: High levels of the circulating form of parathyroid hormone do not inhibit in vitro erythropoiesis. J Lab Clin Med 102: 613, 1983PubMedGoogle Scholar
  36. 36.
    McGonigle RJS, Keogh AM, Weston JM, Parsons V, Crofts MAJ: Iron status in chronic hemodialysis patients - treatment of transfusional iron overload with desferrioxamine. Dial Transplant 13: 214, 1984Google Scholar
  37. 37.
    Segal GM, Eschbach JW, Egrie JC, Stueve T, Adamson JW: The anemia of end-stage renal disease: Progenitor cell response. Kidney Int 33: 983, 1988PubMedCrossRefGoogle Scholar
  38. 38.
    Adamson JW, Eschbach JW, Finch CA: The kidney and erythropoiesis. Am J Med 44: 725, 1968PubMedCrossRefGoogle Scholar
  39. 39.
    Chaplin H, Mollison PL: Red cell life-span in nephritis and in hepatic cirrhosis. Clin Sci 12: 351, 1953PubMedGoogle Scholar
  40. 40.
    Loge JP, Lange RD, Moore CV: Characterization of the anemia associated with chronic renal insufficiency. Am J Med 24: 4, 1958PubMedCrossRefGoogle Scholar
  41. 41.
    Lewis JH, Zucker MB, Ferguson JH: Bleeding tendency in uremia. Blood 11: 1073, 1956PubMedGoogle Scholar
  42. 42.
    Deykin D: Uremic bleeding. Kidney Int 24: 698, 1983PubMedCrossRefGoogle Scholar
  43. 43.
    Lindsay RM, Moorthy AV, Koens F, Linton AL: Platelet function in dialyzed and non-dialyzed patients with chronic renal failure. Clin Nephrol 4: 50, 1975Google Scholar
  44. 44.
    Remuzzi G, Livio M, Marchiaro G, Mecca G, de Gaetano G: Bleeding in renal failure: Altered platelet function in chronic uraemia only partially corrected by haemodialysis. Nephron 22: 347, 1978PubMedCrossRefGoogle Scholar
  45. 45.
    Koch KM, Patyna WD, Shaldon S, Werner E: Anemia of the regular hemodialysis patient and its treatment. Nephron 12: 405, 1974PubMedCrossRefGoogle Scholar
  46. 46.
    Eschbach JW, Korn D, Finch CA: 14C cyanate as a tag for red cell survival in normal and uremic man. J Lab Clin Med 89: 823, 1977PubMedGoogle Scholar
  47. 47.
    Eschbach JW, Adamson JW, Cook JD: Disorders of red blood cell production in uremia. Arch Intern Med 126: 812, 1970PubMedCrossRefGoogle Scholar
  48. 48.
    Zappacosta AR, Caro J, Erslev A: Normalization of hematocrit in patients with end-stage renal disease on continuous ambulatory peritoneal dialysis. Am J Med 72: 53, 1982PubMedCrossRefGoogle Scholar
  49. 49.
    De Paepe MBJ, Schelstraete KHG, Ringoir SMG, Lameire NH: Influence of continuous ambulatory peritoneal dialysis on the anemia of endstage renal disease. Kidney Int 23: 744, 1983PubMedCrossRefGoogle Scholar
  50. 50.
    Mehta BR, Mogridge C, Bell JD: Changes in red cell mass, plasma volume and hematocrit in patients on CAPD. Trans Am Soc Artif Intern Organs 24: 50, 1983Google Scholar
  51. 51.
    Chandra M, Clemons G, McVicar M, Bluestone P, Mailloux L: Serum immunoreactive erythropoietin (Ep) levels in patients on continuous ambulatory peritoneal dialysis (CAPD). Kidney Int 27: 178, 1985Google Scholar
  52. 52.
    Charles G, Lundin AP III, Delano BG, Brown C, Friedman EA: Absence of anemia in maintenance hemodialysis. Int J Artif Organs 4: 277, 1981PubMedGoogle Scholar
  53. 53.
    Blumberg A, Marti HR: Red cell metabolism and haemolysis in patients on dialysis. Proc Eur Dial Transplant Assoc 9: 91, 1972PubMedGoogle Scholar
  54. 54.
    Eschbach JW, Funk D, Adamson JW, Kuhn I, Scribner BH, Finch CA: Erythropoiesis in patients with renal failure undergoing chronic dialysis. N Engl J Med 276: 653, 1967PubMedCrossRefGoogle Scholar
  55. 55.
    Kominami N, Lowrie EG, Iahez LE, Sharken A, Hampers CL, Merrill JP, Lange RD: The effect of total nephrectomy on hematopoiesis in patients undergoing chronic hemodialysis. J Lab Clin Med 78: 524, 1971PubMedGoogle Scholar
  56. 56.
    Shalhoub RJ, Rajan U, Kim VV, Goldwasser E, Kark JA, Antoniou LD: Erythrocytosis in patients on long-term hemodialysis. Ann Intern Med 97: 686, 1982PubMedGoogle Scholar
  57. 57.
    Gardner KD: Acquired renal cystic disease and renal adenocarcinoma in patients on long-term hemodialysis. N Engl J Med 310: 390, 1984PubMedGoogle Scholar
  58. 58.
    Levine E, Grantham JJ, Slusher SL, Greathouse JL, Krohn BP: CT of acquired cystic kidney disease and renal tumors in long-term dialysis patients. Am J Radiol 142: 125, 1984Google Scholar
  59. 59.
    Lindsay RM, Burton JA, Dargie HJ, Prentice CRM, Kennedy AC: Dialyzer blood loss. Clin Nephrol 1: 24, 1973PubMedGoogle Scholar
  60. 60.
    Haskins D, Stevens AR Jr, Finch S, Finch CA: Iron metabolism. Iron stores in man as measured by phlebotomy. J Clin Invest 31: 543, 1952PubMedCrossRefGoogle Scholar
  61. 61.
    Fong TP, Smith EC, Thomas W Jr, Westerman MP: Diagnostic significance of bone marrow biopsy in chronic renal disease. Nephron 12: 81, 1974PubMedCrossRefGoogle Scholar
  62. 62.
    Miles LEM, Lipschitz DA, Bieber CP, Cook JD: Measurement of serum ferritin by a 2-site immunoradiometric assay. Anal Biochem 61: 209, 1974PubMedCrossRefGoogle Scholar
  63. 63.
    Jacobs A, Path FRC, Worwood M: Ferritin in serum: Clinical and biological implications. Med Progr 292: 951, 1975Google Scholar
  64. 64.
    Mirahamadi KS, Wellington LP, Winer RL, Dabir-Vaziri N, Byer B, Gorman JT, Rosen SM: Serum ferritin level. Determinant of iron requirement in hemodialysis patients. JAMA 238: 601, 1977CrossRefGoogle Scholar
  65. 65.
    Eschbach JW, Cook JD, Scribner BH, Finch CA: Iron balance in hemodialysis patients. Ann Intern Med 87: 710, 1977PubMedGoogle Scholar
  66. 66.
    Whitehead VM, Comty CH, Posen GA, Kaye M: Homeostasis of folic acid in patients undergoing maintenance hemodialysis. N Engl J Med 279: 970, 1980CrossRefGoogle Scholar
  67. 67.
    Hemmeloff Andersen KE: Folic acid status of patients with chronic renal failure maintained by dialysis. Clin Nephrol 8: 510, 1977PubMedGoogle Scholar
  68. 68.
    Hampers CL, Streiff R, Nathan DG, Snyder D, Merrill JP: Megaloblastic hematopoiesis in uremia and in patients on long-term dialysis. N Engl J Med 276: 551, 1967PubMedCrossRefGoogle Scholar
  69. 69.
    Cunningham J, Sharman VL, Goodwin FJ, Marsh FP: Do patients receiving haemodialysis need folic acid supplements?Br Med J 282: 1582, 1981CrossRefGoogle Scholar
  70. 70.
    Eichner ER, Paine CJ, Dickson VL, Hargrove MD Jr: Clinical and laboratory observations on serum folate-binding protein. Blood 46: 599, 1975PubMedGoogle Scholar
  71. 71.
    Gokal R, Weatherall DJ, Bunch C: Iron induced increase in red cell size in haemodialysis patients. Q J Med 48: 393, 1979PubMedGoogle Scholar
  72. 72.
    Matter BJ, Pederson J, Psimenos G, Lindeman RD: Lethal copper intoxication in hemodialysis. Trans Am Soc Artif Intern Organs 15: 309, 1969PubMedGoogle Scholar
  73. 73.
    Ivanovich P, Manzler A, Drake R: Acute hemolysis following hemodialysis. Trans Am Soc Artif Intern Organs 15: 316, 1969PubMedGoogle Scholar
  74. 74.
    Manzler AD, Schreiner AW: Copper-induced acute hemolytic anemia. A new complication of hemodialysis. Ann Intern Med 73: 409, 1970PubMedGoogle Scholar
  75. 75.
    Higgins MR, Gace M, Ulan RA, Silverberg DS, Bettcher KB, Dossetor JB: Anemia in hemodialysis patients. Arch Intern Med 137: 172, 1977PubMedCrossRefGoogle Scholar
  76. 76.
    Yawata Y, Howe R, Jacob HS: Abnormal red cell metabolism causing hemolysis in uremia. A defect potentiated by tap water hemodialysis. Ann Intern Med 79: 362, 1973PubMedGoogle Scholar
  77. 77.
    Carlson DJ, Shapiro FL: Methemoglobinemia from well water nitrates: A complication of home dialysis. Ann Intern Med 73: 757, 1970PubMedGoogle Scholar
  78. 78.
    Pun KK, Yeung CK, Chan TK: Acute intravascular hemolysis due to accidental formalin intoxication during hemodialysis. Clin Nephrol 21: 188, 1984PubMedGoogle Scholar
  79. 79.
    Berkes SL, Kahn SI, Chazan JA, Garella S: Prolonged hemolysis from overheated dialysate. Ann Intern Med 83: 363, 1975PubMedGoogle Scholar
  80. 80.
    Francos GC, Burke Jr JF, Besarb A, Martinez J, Kirkwood RG, Hummel LA: An unsuspected cause of acute hemolysis during hemodialysis. Trans Am Soe Artif Intern Organs 24: 140, 1983Google Scholar
  81. 81.
    Said R, Quintanilla A, Levin H, Ivanovich P: Acute hemolysis due to profound hypo-osmolality. A complication of hemodialysis. J Dial 1: 447, 1977PubMedGoogle Scholar
  82. 82.
    Short AIK, Winney RJ, Robson JS: Reversible microcytic hypochromic anaemia in dialysis patients due to aluminum intoxication. Proc Eur Dial Transplant Assoc 17: 226, 1980PubMedGoogle Scholar
  83. 83.
    Wills MR, Savory J: Aluminum poisoning: Dialysis encephalophathy, osteomalacia, and anaemia. Lancet I: 29, 1983CrossRefGoogle Scholar
  84. 84.
    Swartz RD: Deferoxamine and aluminum removal. Am J Kidney Dis 6: 358, 1985PubMedGoogle Scholar
  85. 85.
    Kaehny WD, Miller GE, White WL: Relationship between dialyzer reuse and the presence of anti-N-like antibodies in chronic hemodialysis patients. Kidney Int 12: 59, 1977PubMedCrossRefGoogle Scholar
  86. 86.
    Crosson JT, Moulds J, Comty CM, Polesky HF: A clinical study of anti-NDP in the sera of patients in a large repetitive hemodialysis program. Kidney Int 10: 463, 1976PubMedCrossRefGoogle Scholar
  87. 87.
    Fassbinder W, Pilar J, Scheuermann E, Koch M: Formaldehyde and the occurrence of anti-N-like cold agglutinins in RDT patients. Proc Eur Dial Transplant Assoc 13: 333, 1976Google Scholar
  88. 88.
    Asaba H, Bergstrom J, Lundgren G, Sorbo B, Tranaeus A, Zachrisson L: Hypersequestration of 51Cr-labelled erythrocytes as a criterion for splenectomy in regular hemodialysis patients. Clin Nephrol 8: 304, 1977PubMedGoogle Scholar
  89. 89.
    Bischel MD, Neiman RS, Berne TV, Telfer N, Lukes RJ, Barbour BH: Hypersplenism in the uremic hemodialyzed patient. Nephron 9: 146, 1972CrossRefGoogle Scholar
  90. 90.
    Hartley LCJ, Morgan TO, Innis MD, Clunie CJA: Splenectomy for anaemia in patients on regular haemodialysis. Lancet 2: 1343, 1971PubMedCrossRefGoogle Scholar
  91. 91.
    Weinberg SG, Lubin A, Wiener S, Deoras MP, Ghose MK, Kopelman RC: Myelofibrosis and renal osteodystrophy. Am J Med 63: 755, 1977PubMedCrossRefGoogle Scholar
  92. 92.
    Bommer J, Ritz E, Waldherr R: Silicone-induced splenomegaly. N Engl J Med 305, 1077, 1981PubMedCrossRefGoogle Scholar
  93. 93.
    Rosenmund A, Binswanger U, Straub PW: Oxidative injury to erythrocytes, cell rigidity, and splenic hemolysis in hemodialyzed uremic patients. Ann Intern Med 82: 460, 1975PubMedGoogle Scholar
  94. 94.
    Morgan T, Innes M, Ribush N: The management of the anaemia of patients on chronic haemodialysis. Med J Aust 1: 848, 1972PubMedGoogle Scholar
  95. 95.
    Lichtman MA, Miller DR, Freeman RB: Erythrocyte adenosine triphosphate depletion during hypophosphatemia in a uremic subject. N Engl J Med 280: 240, 1969PubMedCrossRefGoogle Scholar
  96. 96.
    Stenzel KH, Cheigh JS, Sullivan JF, Tapia L, Riggio RR, Rubin AL: Clinical effects of bilateral nephrectromy. Am J Med 58: 69, 1975PubMedCrossRefGoogle Scholar
  97. 97.
    DeKlerk G, Wilmink JM, Rosengarten PCJ, Vet RJWM, Goudsmit R: Serum erythropoietin (ESF) titers in anemia of chronic renal failure. J Lab Clin Med 100: 720, 1982Google Scholar
  98. 98.
    Eschbach JW: Iron kinetics in healthy individuals and in chronic renal insufficiency. Contr Nephrol 38: 129, 1983Google Scholar
  99. 99.
    Gurney CW, Jacobson LO, Goldwasser E: The physiologic and clinical significance of erythropoietin. Ann Intern Med 49: 363, 1958PubMedGoogle Scholar
  100. 100.
    Eschbach JW, Detter JC, Adamson JW: Physiologic studies in normal and uremic sheep. II. Changes in erythropoiesis and oxygen transport. Kidney Int 18: 732, 1980PubMedCrossRefGoogle Scholar
  101. 101.
    Van Ypersele de Strihou, Stragier A: Effect of bilateral nephrectomy on transfusion requirements of patients undergoing chronic dialysis. Lancet 2: 705, 1969Google Scholar
  102. 102.
    Walle AJ, Wong GY, Clemons GK, Garcia JF, Niedermayer W: Erythropoietin-hematocrit feedback in the anemia of end-stage renal disease. Kidney Int 31: 1205, 1987PubMedCrossRefGoogle Scholar
  103. 103.
    Eschbach JW, unpublished observations.Google Scholar
  104. 104.
    Eschbach JW, Adamson JW: Recombinant human erythropoietin: implications for nephrology. Am J Kidney Dis 11: 203, 1988PubMedGoogle Scholar
  105. 105.
    Trapp GA: Plasma aluminum is bound to transferrin. Life Sci 33: 3111, 1983CrossRefGoogle Scholar
  106. 106.
    Winearls CG: personal observation.Google Scholar
  107. 107.
    Shasha SM, Better OS, Winaver J, Chaimovitz C, Barzilai A, Erlik D: Improvement in the anemia of hemodialyzed patients following subtotal parathyroidectomy. Israel J Med Sci 14: 328, 1978PubMedGoogle Scholar
  108. 108.
    Zingraff J, Drüeke T, Marie P, Man NK, Jungers P, Bordier P: Anemia and secondary hyperparathyroidism. Arch Intern Med 138: 1650, 1978PubMedCrossRefGoogle Scholar
  109. 109.
    Potasman I, Better OS: The role of secondary hyperparathyroidism in the anemia of chronic renal failure. Nephron 33: 229, 1983PubMedCrossRefGoogle Scholar
  110. 110.
    Barbour GL: Effect of parathyroidectomy on anemia in chronic renal failure. Arch Intern Med 139: 889, 1979PubMedCrossRefGoogle Scholar
  111. 111.
    Kopple JD, Swendseid ME: Evidence that histidine is an essential amino acid in normal and chronically uremic man. J Clin Invest 55: 881, 1975PubMedCrossRefGoogle Scholar
  112. 112.
    Jontofsohn R, Heinze V, Katz N, Stuber U, Wilke H, Kluthe R: Histidine and iron supplementation in dialysis and pre-dialysis patients. Proc Eur Dial Transplant Assoc 11: 391, 1974Google Scholar
  113. 113.
    Reeves RD, Barbour GL, Robertson CS, Crumb CK: Failure of histidine supplementation to improve anemia in chronic dialysis patients. Am J Clin Nutr 30: 579, 1977PubMedGoogle Scholar
  114. 114.
    Kasakura S, Lowenstein L: The effect of uremic blood on mixed leukocyte reaction and cultures of leukocytes with PHA. Transplantation 2: 283, 1967CrossRefGoogle Scholar
  115. 115.
    Wallner SF, Ward HP, Vautrin R, Alfrey AC, Mishell J: The anemia of chronic renal failure: In vitro response of bone marrow to erythropoietin (38931). Proc Soc Exp Biol Med 149: 939, 1975PubMedGoogle Scholar
  116. 116.
    Lin F-K, Suggs S, Lin C-H, Browne JK, Smalling R, Egrie JC, Chen KK, Fox GM, Martin F, Stabinsky Z: Cloning and expression of the human erythropoietin gene. Proc Natl Acad Sci USA 82: 7580, 1985PubMedCrossRefGoogle Scholar
  117. 117.
    Egrie JC, Eschbach JW, Adamson JW: Pharmacokinetics of recombinant human erythropoietin (r-HuEpo) administered to hemodialysis patients. Kidney Int 33: 262, 1988Google Scholar
  118. 118.
    Finch CA: The detection of iron overload. N Engl J Med 307: 1702, 1982PubMedCrossRefGoogle Scholar
  119. 119.
    Gokal R, Millard PR, Weatherall DJ, Callender STE, Ledingham JGG, Oliver DO: Iron metabolism in haemodialysis patients. Q J Med 48: 369, 1979PubMedGoogle Scholar
  120. 120.
    Strickland ID, Chaput de Saintonge DM, Boulton FE, Francis B, Roubikova J, Waters JI: The therapeutic equivalence of oral and intravenous iron in renal dialysis patients. Clin Nephrol 7: 55, 1977PubMedGoogle Scholar
  121. 121.
    Parker PA, Izard MW, Maher JF: Therapy of iron deficiency anemia in patients on maintenance dialysis. Nephron 23: 181, 1979PubMedCrossRefGoogle Scholar
  122. 122.
    Hamstra RD, Block MH, Schocket AL: Intravenous iron dextran in clinical medicine. JAMA 243: 1726, 1980PubMedCrossRefGoogle Scholar
  123. 123.
    Neff MS, Goldberg J, Slifkin RF, Eiser AR, Calamia V, Kaplan M, Baez A, Gupta S, Mattoo N: A comparison of androgens for anemia in patients on hemodialysis. N Engl J Med 304: 871, 1981PubMedCrossRefGoogle Scholar
  124. 124.
    Eschbach JW, Adamson JW: Improvement in the anemia of chronic renal failure with fluoxymesterone. Ann Intern Med 78: 527, 1973PubMedGoogle Scholar
  125. 125.
    Radtke HW, Erbes PM, Schippers E, Koch KM: Serum erythropoietin concentration in anephric patients. Nephron 2: 361, 1978CrossRefGoogle Scholar
  126. 126.
    Shaldon S, Koch KM, Opperman F, Patyna WD: Testosterone therapy for anaemia in maintenance dialysis. Br Med J 3: 212, 1971PubMedCrossRefGoogle Scholar
  127. 127.
    Singer JW, Adamson JW: Steroids and hematopoiesis. II. The effect of steroids on in vitro erythroid colony growth: Evidence for different target cells for different classes of steroids. J Cell Physiol 88: 135, 1976PubMedCrossRefGoogle Scholar
  128. 128.
    Ahmad S, Goodman W, Pagel M, Shen F: Accelerated creatinine generation and elevated CPK due to androgens. Proc Clin Dial Transplant Forum 10: 174, 1980PubMedGoogle Scholar
  129. 129.
    Editorial. Androgens in the anaemia of chronic renal failure. Br Med J 2: 417, 1977CrossRefGoogle Scholar
  130. 130.
    Goldberg AP, Hagberg JM, Delmez JA, Haynes ME, Harter HR: Metabolic effects of exercise training in hemodialysis patients. Kidney Int 18: 754, 1980PubMedCrossRefGoogle Scholar
  131. 131.
    Curtis JR, Goode GC, Herrington J, Urdaneta LE: Possible cobalt toxicity in maintenance hemodialysis patients after treatment with cobaltous chloride: A study of blood and tissue cobalt concentrations in normal subjects and patients with terminal renal failure. Clin Nephrol 5: 61, 1976PubMedGoogle Scholar
  132. 132.
    Editorial: Cobalt in severe renal failure. Lancet 2: 26, 1976Google Scholar
  133. 133.
    Santiago GC, Rao TKS, Laird NM: Effect of dialysis therapy on the hematopoietic system: The National Cooperative Dialysis Study. Kidney Int 23 (Suppl 13): S95, 1983Google Scholar
  134. 134.
    Teschan PE, Ginn HE, Bourne JR, Ward JR, Schaffer JD: A prospective study of renal dialysis. Trans Am Soc Artif Intern Organs J 3: 108, 1983Google Scholar
  135. 135.
    Stefanidis CJ, Papadakis JT, Patrikarea A, Christodoulidou Ch, Ziroyannis PN, Papadoyannakis NJ: The effect of nutrition on anemia of patients on hemodialysis. Kidney Int (Abstract) 31: 870, 1987Google Scholar
  136. 136.
    Hegsted DM: The correlation of serum ferritin and body iron stores. Nutr Rev 33: 11, 1975Google Scholar
  137. 137.
    Schafer AI, Cheron RG, Dluhy R, Cooper B, Gleason RE, Soeldner JS, Bunn HF: Clinical consequences of acquired transfusional iron overload in adults. N Engl J Med 304: 319, 1981PubMedCrossRefGoogle Scholar
  138. 138.
    Bregman H, Winchester JF, Knepshield JH, Gelfand MC, Manz HJ, Schreiner GE: Iron-overload-associated myopathy in patients on maintenance haemodialysis: A histocompatibility-linked disorder. Lancet 2: 882, 1980PubMedCrossRefGoogle Scholar
  139. 139.
    Simon P, Brissot P: Hemosiderosis and hemochromatosis in maintenance hemodialysis patients: Diagnosis and treatment by desferoxamine. Kidney Int 20: 311, 1981Google Scholar
  140. 140.
    McGonigle RJS, Keogh AM, Weston JM, Parsons V, Crofts MAJ: Iron status in chronic hemodialysis patients - treatment of transfusional iron overload with desferrioxamine. Dial Transplant 13: 214, 1984Google Scholar
  141. 141.
    Horowitz HI, Stein IM, Cohen BD, White JG: Further studies on the platelet-inhibitory effect of guanidinosuccinic acid and its role in uremic bleeding. Am J Med 49: 336, 1970PubMedCrossRefGoogle Scholar
  142. 142.
    Rabiner SF, Molinas F: The role of phenol and phenolic acids on the thrombocytopathy and defective platelet aggregation of patients with renal failure. Am J Med 49: 346, 1970PubMedCrossRefGoogle Scholar
  143. 143.
    Huebsch LB, Harker LA: Disorders of platelet function. West J Med 134: 109, 1981PubMedGoogle Scholar
  144. 144.
    Shattil SJ, Bennett JS: Platelets and their membranes in hemostasis: Physiology and pathophysiology. Ann Intern Med 94: 108, 1981PubMedGoogle Scholar
  145. 145.
    Castaldi PA, Rozenberg MC, Stewart JH: The bleeding disorder or uraemia. A qualitative platelet defect. Lancet 2: 66, 1966PubMedCrossRefGoogle Scholar
  146. 146.
    Nenci GG, Berrettini M, Agnelli G, Parise P, Buoncristiani U, Ballatori E: Effect of peritoneal dialysis, haemodialysis and kidney transplantation on blood platelet function. I. Platelet aggregation by ADP and epinephrine. Nephron 23: 287, 1979PubMedCrossRefGoogle Scholar
  147. 147.
    Salzman EW, Neri LL: Adhesiveness of blood platelets in uremia. Thromb Diath Haemorrh 15: 84, 1966PubMedGoogle Scholar
  148. 148.
    Remuzzi G: Abnormalities of platelet and coagulation function in renal failure. Kidney Int 27: 101, 1985Google Scholar
  149. 149.
    Horowitz HI: Uremic toxins and platelet function. Arch Intern Med 126: 823, 1970PubMedCrossRefGoogle Scholar
  150. 150.
    Livio M, Marchesi D, Remizzu G, Gotti E, Mecca G, de Gaetano G: Uraemic bleeding: Role of anaemia and beneficial effect of red cell transfusions. Lancet 2: 1013, 1982PubMedCrossRefGoogle Scholar
  151. 151.
    Remuzzi G, Marchesi D, Cavenaghi AE, Livio M, Donati MB, de Gaetano G, Mecca G: Bleeding in renal failure: A possible role of vascular prostacyclin (PGL). Clin Nephrol 12: 127, 1979PubMedGoogle Scholar
  152. 152.
    Remuzzi G, Dodesini P, Livio M, Mecca G, Benigni A, Schieppati A, Poletti E, de Gaetano G: Parathyroid hormone inhibits human platelet function. Lancet 2: 1321, 1981PubMedCrossRefGoogle Scholar
  153. 153.
    Docci D, Turci F, Delvecchio C, Gollini C, Baldrati L, Pistocchi E: Lack of evidence for the role of secondary hyperparathyroidism in the pathogenesis of uremic thrombocytopathy. Nephron 43: 28, 1986PubMedCrossRefGoogle Scholar
  154. 154.
    Jubelirer SJ: Hemostatic abnormalities in renal disease. Am J Kidney Dis 5: 219, 1985PubMedGoogle Scholar
  155. 155.
    Harker LA, Slichter SJ: The bleeding time as a screening test for evaluation of platelet function. N Engl J Med 287: 155, 1972PubMedCrossRefGoogle Scholar
  156. 156.
    Lindsay RM, Moorthy AV, Koens F, Linton AL: Platelet function in dialyzed and non-dialyzed patient with chronic renal failure. Clin Nephrol 4: 52, 1975PubMedGoogle Scholar
  157. 157.
    Lindsay RM, Friesen M, Koens F, Linton AL, Oreopoulos D, de Veber G: Platelet function in patients on long term peritoneal dialysis. Clin Nephrol 6: 335, 1976PubMedGoogle Scholar
  158. 158.
    Lindsay RM, Friesen M, Aronstam A, Andrus F, Clark WF, Linton AL: Improvement of platelet function by increased frequency of hemodialysis. Clin Nephrol 10: 67, 1978PubMedGoogle Scholar
  159. 159.
    Jorgenson KA, Ingeberg S: Platelets and platelet function in patients with chronic uremia on maintenance hemodialysis. Nephron 23: 233, 1979CrossRefGoogle Scholar
  160. 160.
    Wathen R, Smith M, Keshaviah P, Comty C, Shapiro F: Depressed in vitro aggregation of platelets of chronic hemodialysis patients: A role for cyclic AMP. Trans Am Soc Artif Intern Organs 21: 320, 1975PubMedGoogle Scholar
  161. 161.
    Tenckhoff H: Chronic Peritoneal Dialysis Manual Seattle, University of Washington, 1974Google Scholar
  162. 162.
    Docci D, Turci F, Del Vecchio C, Bilancioni R, Cenciotti L, Pretolani E: Hemodialysis-associated platelet loss: Study of the relative contribution of dialyzer membrane composition and geometry. Int J Artif Organs 7: 337, 1984PubMedGoogle Scholar
  163. 163.
    Hakim RM, Schaefer AI: Hemodialysis-associated platelet activation and thrombocytopenia. Am J Med 78: 575, 1985PubMedCrossRefGoogle Scholar
  164. 164.
    Lindsay RM, Prentice CRM, Davidson JF, Burton JA, McNicol GP: Haemostatic changes during dialysis associated with thrombus formation on dialysis membranes. Br Med J 2: 454, 1972CrossRefGoogle Scholar
  165. 165.
    Rucinski B, Niewiarowski S, James P, Walz DA, Budzynski AZ: Antiheparin proteins secreted by human platelets. Purification, characterization, and radioimmunoassay. Blood 53: 47, 1969Google Scholar
  166. 166.
    Aronstam A, Dennis B, Friesen MJ, Clark WF, Linton AL, Lindsay RM: Heparin neutralizing activity in patients with renal disease on maintenance hemodialysis. Thromb Haemost 39: 695, 1978PubMedGoogle Scholar
  167. 167.
    Lindsay RM: Variable heparin requirements during hemodialysis - Why? Commentary. Trans Am Soe Artif Intern Organs 3: 81, 1980Google Scholar
  168. 168.
    Turney JH, Fewell MR, Williams LC, Parsons V, Weston MJ: Platelet protection and heparin sparing with prostacyclin during regular dialysis therapy. Lancet 2: 219, 1980PubMedCrossRefGoogle Scholar
  169. 169.
    Smith MC, Danviriyasup K, Crow JW, Cato AE, Park GD, Hassid A, Dunn MJ: Prostacyclin substitution for heparin in long-term hemodialysis. Am J Med 73: 669, 1982PubMedCrossRefGoogle Scholar
  170. 170.
    Zusman RM, Rubin RH, Cato AE, Cocchetto DM, Crow JW, Tolkoff-Rubin N: Hemodialysis using prostacyclin instead of heparin as the sole antithrombotic agent. N Engl J Med 304: 934, 1981PubMedCrossRefGoogle Scholar
  171. 171.
    Walker RW, Heaton A: Thrombocytopenia due to vancomycin. Lancet 1: 932, 1985PubMedCrossRefGoogle Scholar
  172. 172.
    Walker JA, Sherman RA, Eisinger RP: Thrombocytopenia associated with intravenous desferrioxamine. Am J Kidney Dis 4: 254, 1985Google Scholar
  173. 173.
    Vicks SL, Gross ML, Schmitt GW: Massive hemorrhage due to hemodialysis-associated thrombocytopenia. Am J Nephrol 3: 30, 1983PubMedCrossRefGoogle Scholar
  174. 174.
    Casati S, Passerini P, Graziani G, Moia M, Delia Valle P, Mannucci PM, Ponticelli C: Human recombinant erythropoietin corrects anemia and bleeding tendency in hemodialysis patients. Abstracts Int Congr Nephrol 10: 129, 1987Google Scholar
  175. 175.
    Mannucci PM, Remuzzi G, Pusineri F, Lombardi R, Valsecchi C, Mecca G, Zimmerman TS: Deamino-8-d-arginine vasopressin shortens the bleeding time in uremia. N Engl J Med 308: 8, 1983PubMedCrossRefGoogle Scholar
  176. 176.
    Janson PA, Jubeliere SJ, Weinstein MJ, Deykin D: Treatment of the bleeding tendency in uremia with cryoprecipitate. N Engl J Med 303: 1318, 1980PubMedCrossRefGoogle Scholar
  177. 177.
    Lindsay RM, Ferguson D, Prentice CRM, Burton JA, McNicol GP: Reduction of thrombus formation on dialyser membranes by aspirin and RA 233. Lancet 2: 1287, 1972PubMedCrossRefGoogle Scholar
  178. 178.
    Harter HR, Burch JW, Majerus PW, Stanford N, Delmez JA, Anderson CB, Weerts C: Prevention of thrombosis in patients on hemodialysis by low-dose aspirin. N Engl J Med 301: 577, 1979PubMedCrossRefGoogle Scholar
  179. 179.
    Hoy WE, Cestero RVM, Freeman RB: Deficiency of T and B lymphocytes in uremic subjects and partial improvement with maintenance hemodialysis. Nephron 20: 182, 1978PubMedCrossRefGoogle Scholar
  180. 180.
    Kurz P, Kohler H, Meuer S, Hutterroth T, Meyer zum Buschenfelde K-H: Impaired cellular immune responses in chronic renal failure: Evidence for a T cell defect. Kidney Int 29: 1209, 1986PubMedCrossRefGoogle Scholar
  181. 181.
    Raska K Jr, Raskova J, Shea SM, Frankel RM, Wood RH, Lifter J, Ghobrial I, Eisinger RP, Homer L: T cell subsets and cellular immunity in end-stage renal disease. Am J Med 75: 734, 1983PubMedCrossRefGoogle Scholar
  182. 182.
    Raskova J, Ghobrial I, Shea SM, Eisinger RP, Raska K Jr: Suppressor cells in end-stage renal disease. Am J Med:76 847, 1984PubMedCrossRefGoogle Scholar
  183. 183.
    Smith MD, Hardy G, Williams JD, Coles GA: Suppressor cell numbers and activity in non-transfused renal dialysis patients. Clin Nephrol 20: 130, 1983PubMedGoogle Scholar
  184. 184.
    Lewis SL, Van Epps DE: Neutrophil and monocyte alterations in chronic dialysis patients. Am J Kidney Dis 9: 381, 1987PubMedGoogle Scholar
  185. 185.
    Kaplow LS, Goffinet JA: Profound neutropenia during the early phase of hemodialysis. JAMA 203: 1135, 1968PubMedCrossRefGoogle Scholar
  186. 186.
    Gral T, Schroth P, DePalma JR, Gordon A: Leukocyte dynamics with three types of hemodialyzers. Trans Am Soc Artif Intern Organs 15: 45, 1969PubMedGoogle Scholar
  187. 187.
    Brubaker LH, Nolph KD: Mechanisms of recovery from neutropenia induced by hemodialysis. Blood 38: 623, 1971PubMedGoogle Scholar
  188. 188.
    Lewis SL, Van Epps DE, Chenoweth DE: Leukocyte C5a receptor modulation during hemodialysis. Kidney Int 31: 112, 1987PubMedCrossRefGoogle Scholar
  189. 189.
    Craddock PR, Fehr J, Brigham KL, Kronenberg RS, Jacob HS: Complement and leukocyte-mediated pulmonary dysfunction in hemodialysis. N Engl J Med 296: 769, 1977PubMedCrossRefGoogle Scholar
  190. 190.
    Savdie E, Bruce L, Vincent PC: Modified neutropenic response to re-used dialyzers in patients with chronic renal failure. Clin Nephrol 8: 422, 1977PubMedGoogle Scholar

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© Kluwer Academic Publishers 1989

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  • Joseph W. Eschbach

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