Prior to beginning to administration erythropoietin (EPO) in 1989, we examined the relationships of hematocrit (HCT), mean corpuscular volume (MCV), and serum ferritin (FER) in one group of hemodialysis patients (group A, n = 117) and replicated the findings in a second group (group B, n = 73). The groups had similar mean ( ± SD) HCT (A: 25.7 ± 5.3%; B: 25.2 ± 5.1%), MCV (A: 83.3 ± 6.5 fl; B: 83.5 ± 7.5 fl) and FER (A: 607 ± 1446 µg/l; B: 374 + 601 µg/l). For group A, iron stores [log (FER)] correlated inversely with HCT (r = -0.44, p < 10-4) and directly with MCV (r = 0.32, p < 10-3). After dividing group A into octiles by the FER level, the lowest octile (mean FER 17.8 ± 6.2 µg/l) had the highest mean HCT (29.5 ± 6.4%) and lowest mean MCV (80.8 ± 7.1 fl), while the highest octile (mean FER 3,312 ± 3,005 µg/l) had the lowest mean HCT (21.9 ± 2.8%) and the second-highest mean MCV (86.4 ± 4.9 fl). The trends were similar in group B. We conclude that increased erythropoiesis appeared to cause or, at least, unmask iron deficiency in HD patients even prior to the advent of EPO therapy. Variations in the level of erythropoiesis among these patients (presumably due to variation in EPO levels, chronic inflammation) strongly influenced the determinants of iron stores (i.e., marrow utilization of iron, transfusion need); iron stores, in turn, influenced MCV.

Keywords:
Hemodialysis, Anemia, Ferritin, Mean corpuscular volume
This content is only available via PDF.
© 1994 S. Karger AG, Basel
1994
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.