Abstract
In the developement of renal anemia, the deficiency of erythropoietin and the presence of toxic substances to supress bone marrow are two major pathogentic factors. In the case of hemodialysis patients, iron deficiency due to intradialyzer residual blood and hemolysis due to exogenous toxins must be considered.
The principle of treatment is to eliminate the two major factors. Although erythropoietin supplement is not available today, the androgens can stimulate erythropoietin secretion and also act directly on bone marrow to stimulate eythropoiesis. To eliminate toxins of middle molecular weight, hemofiltration and peritoneal dialysis are effective. We described the experiences about the effect of mepitiostane, the androgen derivative newly developed in Japan, and as well the effect of long term hemofiltration. Mepitiostane is very effective to raise hematocrit and causes liver dysfunction rarely. The combination of the drug and hemofiltration is expected to be more effective.
