Abstract
Aim: To determine RBC survival in hemodialysis (HD) compared to age and gender-matched controls.
Background: Decreased RBC survival contributes to the anemia of chronic kidney disease. The uremic environment accounts for the reduced RBC life span. Reductions of up to 70% in RBC survival have been reported in uremic patients. The impact of mechanical damage caused by hemodialysis to the shortened lifespan remains unclear. Reductions up to 70% in RBC survival have been reported in uremic patients. No accurate, well-controlled RBC survival data exists in dialysis patients on different dialysis modalities and under erythropoiesis stimulating agent (ESA) therapy.
Methods: Fourteen HD patients and 14 healthy subjects age and gender-matched to the HD subjects, were recruited. In addition, five PD patients were also recruited. All dialysis patients were on ESA therapy or received regular iron supplementations. RBC survival was determined by radioactive chromium labeling and included potential losses due to elution and vesiculation.
Results: Median (IQR) RBC survival was significantly reduced by 20% in hemo-dialysis patients compared to healthy subjects (58.1 (54.6–71.2) vs 72.9 (63.4–87.8) days, p < 0.05). There was no difference between the PD and HD groups(55.3 (49.0–60.2) vs (58.1 (54.6–71.2) days, p = ns).
Conclusions: Despite current ESA therapy, reduced RBC survival contributes to CKD-related anemia, but the reduction is less than previously reported .Mechanical damage related to HD does not appear to contribute to the reduced RBC life span.
Poster presentation.