Abstract
Erythrocyte life-span (ELS) was determined in 16 children with CRF on conservative treatment (CT) and 6 children on regular haemodialysis (HD). Intestinal blood loss was measured during 5-6 days in 4 CT and 6 HD children. Blood loss in the HD equipment (parallel flow dialyzer Gambro) was determined in 6 children at the end of 3 consecutive HD sessions (each 8-10 hrs.) after reperfusion with air and 0.9% NaCl. For all measurements labeling of red blood cells with acetylacetonate mediated 111Indium was used, the advantage of this isotope being a high counting yield and a physical half-life of only 2.8 days. On CT, ELS (M±SD) was significantly lower in the group with BUN > 60 mg% (61 ± 18%) vs. the group with BUN < 60 mg% (76+12 %)vs. adult controls (100%). On HD ELS was 74±17 %. No correlations were found between ELS and serum creatinine or bicarbonate. Intestinal blood loss amounted to 6.7±2.5 on CT and 11.1±1.2 ml/day on HD. Blood loss in tne equipment used for HD was 9.2±5.1 ml per dialysis (25 % in dialyser, 51% in connecting tubing system, 24 % in swabs by cannulation). In conclusion, besides bone marrow dysfunction, haemolysis and blood loss by intestine and by trapping in equipment used for HD contribute essentially to the anemia observed in CRF.
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Müller-Wiefel, D., Sinn, H., Gilli, G. et al. 161: Pathomechanisms of anemia in chronic renal failure (CRF). Pediatr Res 10, 897 (1976). https://doi.org/10.1203/00006450-197610000-00152
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DOI: https://doi.org/10.1203/00006450-197610000-00152