The anemia of chronic renal failure and chronic diseases: in vitro studies
of erythropoiesis
SF Wallner, JE Kurnick, HP Ward, R Vautrin and AC Alfrey
The presence of a serum factor in chronic renal failure (CRF) which
inhibits erythropoietin-stimulated erythropoiesis was studied, using a
technique in which dog marrow cells were stimulated to produce heme in the
presence of human serum. In the total series comparing 27 normal sera with
52 CRF sera, less heme was synthesized when the system contained CRF sera
(total series, p = 0.0001). There was no evidence of inhibition of heme
synthesis by serum from 12 patients with the anemia of chronic diseases
(CD). Mixing experiments with normal and CRF sera suggested that this
defect in CRF serum was not due to lack of a factor necessary for heme
synthesis. Addition of urea, creatinine, and guanidinosuccinic acid to
normal serum did not impair its ability to support erythropoiesis in this
system. These data demonstrated that serum from patients with CRF contains
a material inhibiting erythropoiesis in vitro, We propose that the material
is responsible, in part, for the clinically severe anemia seen in these
patients.
Volume 47,
Issue 4,
pp. 561-569,
04/01/1976
Copyright © 1976 by The American Society of Hematology
