ASSESSING ERYTHROPOIESIS AND THE EFFECT OF ERYTHROPOIETIN THERAPY IN RENAL-DISEASE BY RETICULOCYTE COUNTING

Renal disease is characterized by failure of erythropoietin (Epo) prod uction and low bone marrow sensitivity to Epo. The reticulocyte count is the best laboratory marker of erythropoiesis available, but reticul ocytes have not been extensively studied in renal disease. Cluster ana lysis suggests that in non-haemodialysed renal patients the anaemia is associated with uraemia while the reticulocyte number and immature su bclasses are correlated with the ineffective erythropoietic component of the anaemia. This emphasizes the importance of treating the renal d isease in patients with the anaemia of end-stage renal failure. Human recombinant Epo therapy has been demonstrated to be effective in corre cting anaemia in most cases of chronic renal insufficiency. In renal p atients the reticulocyte count should only be monitored by automated m ethods to assure reliability at low counts.