A Beneficial Effect of the in situ Kidney on in vitro Marrow Erythropoiesis in Chronic Renal Failure

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Abstract
The effect of the in situ kidney on transfusion requirements and in vitro erythropoiesis was investigated in 20 patients with end stage renal disease, undergoing hemodialysis. Of the 12 patients with in situ kidneys, 6 did not require transfusion, whereas the other 6 had an average monthly transfusion requirement of 277 ml of sedimented RBC [red blood cells]. All 8 anephric patients required transfusions with an average requirement of 352 ml of sedimented RBC/mo. Serum erythropoietin activity was inappropriately low for the degree of anemia in all but 1 patient, and bone marrow was uniformly hypocellular. Marrow cells from patients with in situ kidneys exhibited a greater response to erythropoietin than marrow cells from their anephric counterparts. The response was not improved by hemodialysis.