腹膜透析患者の貧血のエリスロポエチン低反応性における溶血の関与について

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  • Contribution of hemolysis to erythropoietin refractory anemia in patients on peritoneal dialysis.

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To investigate the contribution of hemolysis to anemia of peritoneal dialysis patients, we measured serum haptoglobin (Hp) levels in 47 patients on peritoneal dialysis.<br>The 4 patients (8.5%) whose Hp values were below the measurement sensitivity level (<10mg/dl) were assigned the hemolytic group, while another 43 patients (91.5%) were assigned to the non-hemolytic group. Serum lactate dehydrogenase and reticulocyte counts were significantly higher in the hemolytic group than in the non-hemolytic group (540.0±132.8 vs. 405.5±105.0IU/l, p<0.05 and 28.7±6.6 vs. 18.0±9.0‰, p<0.05). Hemoglobin concentration was significantly lower in the hemolytic group than in the non-hemolytic group (8.73±0.78 vs. 9.83±1.00g/dl, p<0.05). Doses of recombinant human erythropoietin tended to be higher in the hemolytic group (33000±6000 units/month vs. 20230±12490 units/month, p=0.051). However, dialysis duration, serum creatinine, β2-microglobulin, intact parathyroid hormone, weekly Kt/V and weekly Ccr were not significantly different between the two groups.<br>The results of this study suggest that hemolysis may be a frequent cause of resistance to recombinant human erythropoietin therapy in peritoneal dialysis patients with anemia.

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