FETAL HEMOGLOBIN IN PATIENTS WITH CHRONIC RENAL-DISEASE

To investigate whether hemoglobin (Hb) synthesis is affected by differ ent treatment protocols used for end-stage renal disease, we analyzed the electrophoretic pattern of hemoglobin in 136 adult patients with c hronic renal failure. Forty-seven patients were not in a dialysis prog ram (ND), 29 individuals were on continuous ambulatory peritoneal dial ysis (CAPD), 33 patients were on hemodialysis (HD), and 27 subjects ha d received a kidney transplant (KT). We found 3.6% hemoglobin C, 1.4% hemoglobin S and 3.6% beta-thalassemia minor as reported in other stud ies of Brazilian patients. In addition, we found increased fetal hemog lobin (Hb F) levels in 7.4% of the patients which contrasts with the r eported 0.01% prevalence rate of hereditary persistence of Hb F in Bra zil. Seven out of ten patients with elevated Hb F belonged to either t he CAPD or the KT group. We postulate that stress erythropoiesis is pr obably the mechanism responsible for the Hb F increase in these patien ts. However, properly designed clinical studies are still necessary to clarify these questions.