Neocytolysis contributes to the anemia of renal disease

L. Rice, C. P. Alfrey, T. Driscoll, C. E. Whitley, D. L. Hachey, W. Suki

Research output: Contribution to journalArticle

71 Scopus citations

Abstract

Neocytolysis is a recently described physiological process affecting the selective hemolysis of young red blood cells in circumstances of plethora. Erythropoietin (EPO) depression appears to initiate the process, providing the rationale to investigate its contributions to the anemia of renal disease. When EPO therapy was withheld, four of five stable hemodialysis patients showed chromium 51 (51Cr) -red cell survival patterns indicative of neocytolysis; red cell survival was short in the first 9 days, then normalized. Two of these four patients received oral 13C-glycine and 15N- glycine, and there was a suggestion of pathological isotope enrichment of stool porphyrins when EPO therapy was held, again supporting selective hemolysis of newly released red cells that take up the isotope (one patient had chronic hemolysis indicated by isotope studies of blood and stool). Thus, neocytolysis can contribute to the anemia of renal disease and explain some unresolved issues about such anemia. One implication is the prediction that intravenous bolus EPO therapy is metabolically and economically inefficient compared with lower doses administered more frequently subcutaneously.

Original languageEnglish (US)
Pages (from-to)59-62
Number of pages4
JournalAmerican Journal of Kidney Diseases
Volume33
Issue number1
DOIs
StatePublished - 1999

Keywords

  • Anemia of renal disease
  • Erythropoietin
  • Hemolytic anemia
  • Neocytolysis

ASJC Scopus subject areas

  • Nephrology

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