Abstract
The anemia associated with renal failure does not respond to usual therapeutic measures. What is the place of repeated massive blood transfusions in the treatment of long-term hemodialized patients? It may be stated that anemia is one of the great problems on uremic patients. On well maintained hemodialysis, transfusion may aggrevate erythropoiesis due to the disturbance of homeostasis. In this report, we investigated a relation of the erythropoiesis to the blood transfusion in long-term hemodialized patients.
Our patients consisted of well-maintained long-term hemodialized patients (Group A) and poorly-maintained (Group B).
Group B required more transfusions than Group A. Group A divided into 3 Groups; Group I did not required transfusion for 6 months or more, Group II did not take blood for 3 or 4 months and Group III tend to require a little transfusion. In the most of Groups I and II, ferrokinetic studies reveal the type of iron deficiency anemia and erythropoietin (ESF) in the plasma are detectable, but Group III showed an ineffective erythropoiesis in ferrokinetics and ESF are not detected except one patient. ESF disappeared after transfusion in the plasma on hemodialized patients. In a case of Group II, ESF in his plasma which had not been detected, appeared on the 50th day after the cessation of transfusion.
In our opinion, it is not necessary to do transfusion in long-term hemodialized patients before symptomes of anemia again become prominent.
