Erythrocyte deformability in dialysed and non‐dialysed uraemic patients

Inauen, W.; Stäubli, M; Descoeudres, C; Rl, Galeazzi; Straub, P W

doi:10.1111/j.1365-2362.1982.tb00955.x

Cited by 35 publications

(12 citation statements)

References 15 publications

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“…This observation is in agreement with earlier findings [23]. From reports [10][11][12] that RBC deformability is significantly impaired in uremia, one might expect WBV to become abnormally elevated following improvement of anemia; however, our results indicate that both PV and WBV (for all levels of hematocrit stud ied at high and low rates of shear) fall within the ranges derived from our normal reference group. These findings suggest that if RBC deformability is in fact impaired in our patients, the degree of impairment is not sufficient to cause an inappropriate rise in blood viscosity, following treatment of anemia with rhEPO.…”

Section: Discussionsupporting

confidence: 66%

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Treatment of Azotemic, Nonoliguric, Anemic Patients with Human Recombinant Erythropoietin Raises Whole-Blood Viscosity Proportional to Hematocrit

Brown¹,

Kieran²,

Thomas³

et al. 1991

Nephron

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It has been reported that patients with azotemia have reduced red blood cell (RBC) deformability. Since this is a major determinant of whole-blood viscosity (WBV) and rigid RBCs increase WBV disproportionately relative to the level of hematocrit, it is conceivable that sustained improvement of hematocrit with recombinant human erythropoietin (rhEPO) therapy in azotemic patients might result in abnormally raised WBV. To address this concern, WBV and plasma viscosity (PV) were measured in 9 adult patients (4 men, 5 women) with anemia (mean hematocrit 29.2 ± 2.7%) and azotemia [mean serum creatinine concentration 339.85 ± 102.44 μmol/l (3.8 ± 1.1 mg/dl)] before and after 6 months of treatment with rhEPO (50–175 U/kg given intravenously thrice weekly). Baseline and post-treatment hematocrit, WBV and PV were compared to values derived in 50 normal adult subjects with normal renal function [25 women, 25 men; mean serum creatinine concentration 79.56 ± 8.84 μmol/l (0.9 ± 0.1 mg/dl), mean hematocrit 42.4 ± 3.7%]. To compare rheologic factors at subnormal hematocrits, blood from subjects with normal renal function was diluted with autologous plasma to achieve a range of hematocrits from 20 to 50%. Because hematocrit is higher in men than in women, we compared men and women study patients with a normal group of the same sex. After 6 months of treatment with rhEPO, (1) mean hematocrit rose 38% from 28.3 ± 2.8 to 39.0 ± 1.0% in men (p = 0.005) and 32% from 30.0 ± 2.9 to 39.6 ± 0.8% in women (p = 0.004); (2) WBV increased in proportion to the ratio noted in our healthy reference group with respect to hematocrit (r = 0.64); (3) WBV measured at high (230 s^-1) and low (23.0 s^-1) rates of shear in men and women was not significantly different from normals (p = 0.5) for all values of hematocrit studied; (4) PV [1.65 ± 0.15 millipascal · second (mPa s) for men, 1.64 ± 0.07 mPa s for women] did not change in either sex and was not significantly different from that of normals (1.63 ± 0.14 mPa s for men, 1.57 ± 0.08 mPa s for women). We conclude that treatment with rhEPO (1) restores hematocrit to normal in anemic nondialysis patients with renal insufficiency, (2) WBV increases appropriately in both sexes with respect to the rhEPO-induced rise in hematocrit and (3) PV is unaltered by rhEPO therapy.

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Section: Discussionsupporting

confidence: 66%

“…Using a microfiltration technique, Docci et al [10] and others [11,12] observed that red blood cell (RBC) deformability is markedly reduced in patients with renal fail ure. Rigid RBCs tend to resist shear deformation; there fore, cell-to-cell viscous interaction increases.…”

Section: Introductionmentioning

confidence: 99%

Treatment of Azotemic, Nonoliguric, Anemic Patients with Human Recombinant Erythropoietin Raises Whole-Blood Viscosity Proportional to Hematocrit

Brown¹,

Kieran²,

Thomas³

et al. 1991

Nephron

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“…Microangiopathy of the subepidermal capillaries [21,22] and reduced erythrocyte deformability [23,24] could also impair maximal skin blood How.…”

Section: Discussionmentioning

confidence: 99%

Arterial Stiffening and Reduced Cutaneous Hyperaemic Response in Patients with End-Stage Renal Failure

Wilkinson

Spence²,

Stewart³

1989

Nephron

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Superficial dermal vasodilatory capacity and indirect segmental systolic arterial pressure were measured in 10 patients with end-stage renal failure and 13 controls. Laser-Doppler flowmetry was used to measure skin blood flow on the dorsum of the feet prior to and during local skin heating to 40 °C. Basal skin blood flow was not significantly different between the two groups (mean 0.8 ± (SD) 0.3 vs. 0.7 ± 0.2 U). Peak stimulated flow at 40 °C was significantly greater in the controls than in the azotaemic patients (10.0 ± 3.5 vs. 3.5 ± 1.6 U, p < 0.01). Stiffening of the major limb arteries was detected in the majority of the azotaemic patients and may have contributed to the reduction in vasodilatory capacity.

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“…Anemia in C R F has been associated with decreased R B C deformability [9], increased magnesium content [10] and potassium content [II], We described an association between R B C rigidity and increased calcium content but found no correlation between calcium content or defor mability and the degree o f anemia [2]. These studies do not show that changes in cation content are directly responsible for R B C dysfunction in uremia.…”

mentioning

confidence: 45%

Erythrocyte Calcium in Chronic Renal Failure

Udden¹

1989

Nephron

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Erythrocyte deformability in dialysed and non‐dialysed uraemic patients

Cited by 35 publications

References 15 publications

Treatment of Azotemic, Nonoliguric, Anemic Patients with Human Recombinant Erythropoietin Raises Whole-Blood Viscosity Proportional to Hematocrit

Treatment of Azotemic, Nonoliguric, Anemic Patients with Human Recombinant Erythropoietin Raises Whole-Blood Viscosity Proportional to Hematocrit

Arterial Stiffening and Reduced Cutaneous Hyperaemic Response in Patients with End-Stage Renal Failure

Erythrocyte Calcium in Chronic Renal Failure

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