Document Detail

Erythrocytosis in patients with renal failure on hemodialysis: study of underlying mechanism by in vitro erythroid culture assay.
MedLine Citation:
PMID:  8330648     Owner:  NLM     Status:  MEDLINE    
Five patients with erythrocytosis associated with renal failure on maintenance hemodialysis were investigated for in vitro erythroid progenitor growth and the effect of their uremic sera on normal erythropoiesis. The duration of hemodialysis prior to discovery of erythrocytosis ranged from 1 week to 96 months. None had acquired cystic disease and no other known cause of increased erythropoietin (Epo) production was identified. With the presence of Epo in cultures, all five patients grew erythroid colonies within normal or higher than normal ranges. Three patients formed spontaneous erythroid colonies in the absence of added Epo; all three fulfilled the clinical diagnosis of polycythemia vera (PV). The uremic sera from patients with PV lacked either a stimulating or an inhibiting effect on normal erythropoiesis. The association between renal failure and PV was coincidental. The other two patients without endogenous erythroid colony formation had enhanced erythropoietic activity in their sera, which increasingly stimulated the erythroid colony growth by normal bone marrow cells as the concentration of the uremic serum was increased. The etiology of increased Epo production in these 2 patients remained undefined during long-term follow-up. The present study on five uremic patients with polycythemia showed two different underlying mechanisms of erythrocytosis--characteristic autonomous erythroid proliferation for PV in three patients and inappropriate idiopathic Epo production in two patients.
L Y Shih; M L Leu
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Experimental hematology     Volume:  21     ISSN:  0301-472X     ISO Abbreviation:  Exp. Hematol.     Publication Date:  1993 Aug 
Date Detail:
Created Date:  1993-08-19     Completed Date:  1993-08-19     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0402313     Medline TA:  Exp Hematol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1239-43     Citation Subset:  IM    
Department of Internal Medicine, Chang Gung Medical College, Chang Gung Memorial Hospital, Taipei, Taiwan, R.O.C.
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MeSH Terms
Blood Cells / cytology
Bone Marrow Cells
Colony-Forming Units Assay
Erythroid Precursor Cells / cytology,  drug effects
Erythropoiesis / physiology
Erythropoietin / pharmacology
Kidney / ultrasonography
Kidney Failure / complications*,  pathology,  therapy*
Liver / ultrasonography
Middle Aged
Polycythemia / etiology*,  pathology,  physiopathology
Renal Dialysis*
Uremia / blood,  physiopathology
Reg. No./Substance:

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