Bone marrow blood formation and iron stores in patients with chronic renal failure on maintenance hemodialysis

Abstract

Iron stores, ferrokinetics and total bone marrow cellularity were determined in 35 hemodialysis patients. Some of the patients received hemotransfusions (group I), the others (group II) androgens and iron supplements. In group I the blood losses amounted to 23.9 +/- 2.4 ml/d, in group II to 7.7 +/- 0.5 ml/d. Serum iron and ferritin levels exceeded the normal values. Iron stores were 0.31 +/- 0.07 mg/100 mg (group I) and 0.25 +/- 0.05 mg/100 mg /100 mg (group II), whereas the normal values are 0.18 +/- 0.02 mg/100 mg desferrioxamine. Total bone marrow cellularity in patients of group I amounted to 8.3 +/- 2.3 . 10(9) cells/kg, and in group II to 27.4 +/- 3.2 . 10(9) cells/kg, while the normal values are 14.1 +/- 1.4 . 10(9) cells/kg. Hemotransfusions suppress considerably ferrokinetic indexes in dialysis patients. In massive blood losses hemotransfusions are the therapy of choice for the anemia, but they suppress blood formation. to correct iatrogenic blood losses, iron and androgens may be administered thus stimulating blood formation.