Abstract
To investigate the relationship between protein metabolism and anemia, we analyzed long-term clinical laboratory data obtained from 31 patients maintained with chronic hemodialysis. Autoregressive (AR) coefficients for each patient were computed with the use of the patient's serial data for the levels of total plasma protein (TP), plasma albumin, plasma gamma globulin, and blood hemoglobin (Hb) concentration for 4 to 7 years. The AR coefficents thus obtained were used to make a differential equation, or its equivalent, specific to the patient and thereby to simulate impulse-response (IR) curves. The IR curves clearly demonstrated that an increase in the levels of TP or albumin, but not gamma globulin, caused to strengthen anemia in most patients. This finding suggested the existence of a feedback loop in the body between albumin production in the liver and hemoglobin production possibly mediated by changes in the hepatic production of erythropoietin.
