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Erythrocytosis in patients with renal failure on hemodialysis: study of underlying mechanism by in vitro erythroid culture assay.
Exp Hematol. 1993 Aug; 21(9):1239-43.EH

Abstract

Five patients with erythrocytosis associated with renal failure on maintenance hemodialysis were investigated for in vitro erythroid progenitor growth and the effect of their uremic sera on normal erythropoiesis. The duration of hemodialysis prior to discovery of erythrocytosis ranged from 1 week to 96 months. None had acquired cystic disease and no other known cause of increased erythropoietin (Epo) production was identified. With the presence of Epo in cultures, all five patients grew erythroid colonies within normal or higher than normal ranges. Three patients formed spontaneous erythroid colonies in the absence of added Epo; all three fulfilled the clinical diagnosis of polycythemia vera (PV). The uremic sera from patients with PV lacked either a stimulating or an inhibiting effect on normal erythropoiesis. The association between renal failure and PV was coincidental. The other two patients without endogenous erythroid colony formation had enhanced erythropoietic activity in their sera, which increasingly stimulated the erythroid colony growth by normal bone marrow cells as the concentration of the uremic serum was increased. The etiology of increased Epo production in these 2 patients remained undefined during long-term follow-up. The present study on five uremic patients with polycythemia showed two different underlying mechanisms of erythrocytosis--characteristic autonomous erythroid proliferation for PV in three patients and inappropriate idiopathic Epo production in two patients.

Authors+Show Affiliations

Department of Internal Medicine, Chang Gung Medical College, Chang Gung Memorial Hospital, Taipei, Taiwan, R.O.C.No affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

8330648

Citation

Shih, L Y., and M L. Leu. "Erythrocytosis in Patients With Renal Failure On Hemodialysis: Study of Underlying Mechanism By in Vitro Erythroid Culture Assay." Experimental Hematology, vol. 21, no. 9, 1993, pp. 1239-43.
Shih LY, Leu ML. Erythrocytosis in patients with renal failure on hemodialysis: study of underlying mechanism by in vitro erythroid culture assay. Exp Hematol. 1993;21(9):1239-43.
Shih, L. Y., & Leu, M. L. (1993). Erythrocytosis in patients with renal failure on hemodialysis: study of underlying mechanism by in vitro erythroid culture assay. Experimental Hematology, 21(9), 1239-43.
Shih LY, Leu ML. Erythrocytosis in Patients With Renal Failure On Hemodialysis: Study of Underlying Mechanism By in Vitro Erythroid Culture Assay. Exp Hematol. 1993;21(9):1239-43. PubMed PMID: 8330648.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Erythrocytosis in patients with renal failure on hemodialysis: study of underlying mechanism by in vitro erythroid culture assay. AU - Shih,L Y, AU - Leu,M L, PY - 1993/8/1/pubmed PY - 1993/8/1/medline PY - 1993/8/1/entrez SP - 1239 EP - 43 JF - Experimental hematology JO - Exp Hematol VL - 21 IS - 9 N2 - Five patients with erythrocytosis associated with renal failure on maintenance hemodialysis were investigated for in vitro erythroid progenitor growth and the effect of their uremic sera on normal erythropoiesis. The duration of hemodialysis prior to discovery of erythrocytosis ranged from 1 week to 96 months. None had acquired cystic disease and no other known cause of increased erythropoietin (Epo) production was identified. With the presence of Epo in cultures, all five patients grew erythroid colonies within normal or higher than normal ranges. Three patients formed spontaneous erythroid colonies in the absence of added Epo; all three fulfilled the clinical diagnosis of polycythemia vera (PV). The uremic sera from patients with PV lacked either a stimulating or an inhibiting effect on normal erythropoiesis. The association between renal failure and PV was coincidental. The other two patients without endogenous erythroid colony formation had enhanced erythropoietic activity in their sera, which increasingly stimulated the erythroid colony growth by normal bone marrow cells as the concentration of the uremic serum was increased. The etiology of increased Epo production in these 2 patients remained undefined during long-term follow-up. The present study on five uremic patients with polycythemia showed two different underlying mechanisms of erythrocytosis--characteristic autonomous erythroid proliferation for PV in three patients and inappropriate idiopathic Epo production in two patients. SN - 0301-472X UR - https://www.unboundmedicine.com/medline/citation/8330648/Erythrocytosis_in_patients_with_renal_failure_on_hemodialysis:_study_of_underlying_mechanism_by_in_vitro_erythroid_culture_assay_ L2 - https://medlineplus.gov/dialysis.html DB - PRIME DP - Unbound Medicine ER -