Year: 1968
Type: article
Study design: Case Report
Abstract: Some of the data presented in this Anna1 suggest that in man total absence of renal tissue does not inhibit erythropoiesis more markedly than does severe uremia itself.We will present more confirmatory evidence of this statement, as well as some studies of the metabolism of uremic erythrocytes, which have led us to a general hypothesis regarding the pathogenesis of uremia.Three years ago we presented erythrokinetic investigations of four patients made anephric in preparation for renal transplantation.'These studies revealed decreased erythropoiesis, with maximal RBC 59Fe uptakes in the range of 35 to 70%.However, these patients were able to maintain hemoglobin levels of from 7-9 g percent.Furthermore, a sharply increased erythropoietic effort occurred in one patient who became hypoxic while in the anephric state.These results were interpreted as indications that in humans, in contrast to dogs, a basal rate of erythropoiesis exists which does not require the presence of kidneys, and that an augmented erythropoietic effort can occur without the participation of erythropoietin of renal origin.We have now studied an additional three anephric patients.The results are shown in FIGURE 1. Two patients showed decreased plasma 59Fe clearance rates and all three had depressed effective erythropoiesis, with maximal RBC 59Fe uptake ranging from 3 1 to 44%.
Authors: David G. Nathan, Laurence H. Beck, Constantine L. Hampers, John P. Merrill
Institution: Harvard University
Language: English
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2143486117