Blumberg A
Departement Medizin, Kantonsspital Aarau, Schweiz.
Nephron. 1989;51 Suppl 1:15-9. doi: 10.1159/000185565.
Several factors contribute to the pathogenesis of anemia due to renal failure. Hypoproliferation of red cell progenitors may be caused partially by an inhibitory effect of some 'uremic toxins' whose existence certainly is very controversial. Iron deficiency due to gastrointestinal and dialysis-related blood losses and occasionally aluminum intoxication may interfere with the maturation of the erythron. Moderate hemolysis with shortening of red cell survival to some 50% of normal may be an additional factor. The main cause of anemia is, however, inadequate production of erythropoietin by the diseased kidney. This latter factor has now become amenable to treatment.
有几个因素导致肾衰竭所致贫血的发病机制。红细胞祖细胞的增殖减少可能部分是由一些“尿毒症毒素”的抑制作用引起的,而这些毒素的存在确实极具争议。胃肠道和透析相关失血导致的缺铁以及偶尔的铝中毒可能会干扰红细胞生成。红细胞存活时间缩短至正常的约50%的中度溶血可能是另一个因素。然而,贫血的主要原因是患病肾脏产生促红细胞生成素不足。后一个因素现在已可进行治疗。