THE RATE AND CONTROL OF BASE-LINE RED-CELL PRODUCTION IN HEMATOLOGICALLY STABLE PATIENTS WITH UREMIA

It is generally accepted that the anemia of uremia is caused by decrea sed production of erythropoietin. Nevertheless, the erythropoietin tit ers are not lower than but equal to or higher than in normal non-anemi c individuals, To examine this discrepancy, erythrokinetic studies wer e made of 22 hematologically stable dialysis patients without clinical or laboratory evidence of extrarenal inflammation, infection, or neop lastic disorders. The red cell life span was normal in 14, and because of stable hematocrits, their daily rate of red cell production had to equal their daily rate of red cell destruction, which could be determ ined by dividing the red cell mass by red cell life span. These rates were about one half the rates of normal stable individuals, despite th e same or higher erythropoietin titers. This suggests that the anemia of uremia is caused in part by a decreased bone marrow response to end ogenous erythropoietin.