Megaloblastic Hematopoiesis in Uremia and in Patients on Long-Term Hemodialysis

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Abstract
SEVERE chronic renal failure has an adverse effect on hematopoiesis.1 The major defect appears to be one of relative bone-marrow failure in that the marrow of the patient with uremia does not respond to anemic stress to the same extent as normal marrow.2 The role of erythropoietin in this bone-marrow failure is in doubt.2 It may be that circulating "toxins" play a major part and depress the marrow directly.3 , 4 Another possibility is nutritional deficiency or a deranged metabolism of vitamins in uremic patients. Many marrows that we have examined in patients with chronic renal failure appear megaloblastic, particularly in the . . .

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