Improvement of anaemia in haemodialysed patients after viral or toxic hepatic cytolysis

Thirty patients receiving haemodialysis, including two who had undergone bilateral nephrectomy, showed significant increases (p less than 0.001) in packed cell volume, haemoglobin concentration, and reticulocyte count during an episode of viral or toxic liver cytolysis. In 19 cases the episode laste...

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Bibliographic Details
Published in:BMJ 1980-03, Vol.280 (6218), p.892-894
Main Authors: Simon, P, Meyrier, A, Tanquerel, T, Ang, K S
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Anemia
Anemia - etiology
Anemia - prevention & control
Biopsies
Chemical and Drug Induced Liver Injury - blood
Chemical and Drug Induced Liver Injury - complications
Cytolysis
Dialysis
Erythrocyte Count
Erythrocyte Indices
Erythropoiesis
Female
Hematocrit
Hemoglobins - analysis
Hepatitis
Hepatitis antigens
Hepatitis, Viral, Human - blood
Hepatitis, Viral, Human - complications
Humans
Kidney Failure, Chronic - blood
Kidney Failure, Chronic - complications
Kidney Failure, Chronic - therapy
Liver
Male
Middle Aged
Renal Dialysis
Reticulocytes
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Summary:Thirty patients receiving haemodialysis, including two who had undergone bilateral nephrectomy, showed significant increases (p less than 0.001) in packed cell volume, haemoglobin concentration, and reticulocyte count during an episode of viral or toxic liver cytolysis. In 19 cases the episode lasted a mean of 5.0 +/- SD 2.9 months and was accompanied by improved haematological values for a mean of 12.0 +/- 6.0 weeks. Of the remaining patients, in whom the episode lasted a mean of 8.0 +/- 3.5 months (p less than 0.02), seven showed continued improvement a mean of 30.0 +/- 16.0 weeks after cytolysis. In eight patients in this group there was an apparent correlation between persistently increased haemoglobin concentrations and biopsy evidence of chronic hepatitis. The findings suggest that the reduction in anaemia resulted from enhanced red-cell production mediated by secretion of erythropoietin from regenerating liver cells. If confirmed this might have important implications for the treatment of anaemia in chronic renal insufficiency.
ISSN:0007-1447
0959-8138
1468-5833
DOI:10.1136/bmj.280.6218.892