Uremic toxins as a pathogenic factor of anemia in patients on maintenance dialysis

概要

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To elucidate the pathogenic role of uremic toxins for anemia in patients on maintenance dialysis, the case analysis, erythrocyte osmotic fragility and serum concentration of uremic metabolites were studied, and the following results were obtained. 1) There were the patients whose hematocrit (Hct) changed along with the change of uremic toxins removal by alteration of dialysis regimen. 2) Osmotic resistance of erythrocyte in 38 hemodialysed patients was decreased and urea, creatinine and middle molecular substances had the effect on decreasing the osmotic resistance of erythrocyte in vitro. 3) There were significant inverse relationship between Hct and serum urea nitrogen levels and also serum middle molecules levels in 66 patients on maintenance dialysis. Serum creatinine and guanidino compounds concentrations tended to inversely correlate to Hct. 4) The patients on CAPD (continuous ambulatory peritoneal dialysis) had high Hct levels accompanying with low serum uremic toxins levels, especially urea and middle molecules, as compared to other dialysis regimen such as hemodialysis or hemodiafiltration. In conclusion, uremic toxins may be one of the pathogenic factors of anemia in patients on maintenance dialysis, in paticular the effect of urea and middle molecules may play an important role in it.
社団法人日本透析医学会の論文