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Hematologic Disorders in Renal Failure

 

作者: J.P. Naets,  

 

期刊: Nephron  (Karger Available online 1975)
卷期: Volume 14, issue 2  

页码: 181-194

 

ISSN:1660-8151

 

年代: 1975

 

DOI:10.1159/000180447

 

出版商: S. Karger AG

 

关键词: Anemia;Renal insufficiency;Erythropoietin;Nephrectomy;Hemodialysis;Androgens

 

数据来源: Karger

 

摘要:

Anemia is a frequent complication of renal failure. As in anemias of other origin, the resulting tissular hypoxia is partially compensated by an increased production of 2,3-diphosphoglycerate in red cells and a shift to the right of the oxygen hemoglobin dissociation curve. Two mechanisms are implicated in this anemia: increased hemolysis and depressed production of red cells. Decreased production of erythropoietin is probably the cause of reduced erythropoiesis, but the role of uremic intoxication has not been unequivocally excluded. In the course of chronic hemodialysis, iron deficiency anemia and occasionally hypersplenism develop. It is noteworthy that blood requirements in anephric patients are two to three times greater than those of nonanephric hemodialyzed patients. Accordingly, bilateral nephrectomy should be restricted to carefully selected cases. At the present time, androgens seem to be the best treatment of renal anemia. Qualitative anomalies of platelets are the main factor responsible for uremic bleeding and are corrected by hemodialysis.

 

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