Studies on erythropoiesis in uremic and post-transplant (renal) patients utilizing radioactive iron and chromium.

The association of anemia with chronic renal disease is well known. The striking hematologic improvement following a successful renal allotransplantation led to the present study. Using radioactive (59)Fe, ferrokinetic measurements were carried out in nine uremic patients (seven with and two without anemia), four post-allotransplant cases, three patients with iron deficiency anemia and a group of five normal subjects. Erythrocyte life-span was calculated by (51)Cr-labelled, autotransfused red cells in all patients who had had transplants and in three patients with renal anemia. The results showed that in patients with renal anemia the plasma radioiron clearance was slightly delayed but the (59)Fe incorporation into the circulating erythrocytes was significantly decreased. Red cell life-span was moderately shortened in two out of three uremic patients investigated. The findings constitute evidence of ineffective erythropoiesis in patients with renal anemia. By comparison, the four transplant patients showed normal (59)Fe plasma clearance and red cell incorporation; the (51)Cr erythrocyte survival was normal in all four patients.