Zucker S, Lysik R M, Mohammad G
J Lab Clin Med. 1976 Oct;88(4):528-35.
The diminished erythropoiesis in the anemia of chronic renal disease has been attributed to three possible factors: (1) decreased erythropoietin production, (2) inhibition of erythropoietin activity, and (3) decreased bone marrow response to erythropoietin. In this report we isolated and evaluated these parameters in 19 patients with chronic renal disease, nine patients with iron-deficiency anemia, and seven control subjects. The results in patients with chronic renal failure were as follows: (1) erythropoietin enhanced heme synthesis in bone marrow cell cultures by 88 +/- 12 per cent in renal failure, as compared to 65 +/- 7 per cent in the control group; (2) plasma erythropoietin activity did not increase appropriately for the degree of anemia; and (3) erythropoietin inhibitor activity in renal failure was not greater than in a control group. In conclusion, the relative failure of erythropoiesis in chronic renal disease appears to be due primarily to decreased production of erythropoietin and not to diminished marrow response to erythropoietin.
（1）促红细胞生成素产生减少；（2）促红细胞生成素活性受到抑制；（3）骨髓对促红细胞生成素的反应降低。在本报告中，我们对19例慢性肾病患者、9例缺铁性贫血患者和7名对照受试者的这些参数进行了分离和评估。慢性肾衰竭患者的结果如下：（1）与对照组的65±7%相比，促红细胞生成素使肾衰竭患者骨髓细胞培养中的血红素合成提高了88±12%；（2）血浆促红细胞生成素活性并未随贫血程度而相应增加；（3）肾衰竭患者中促红细胞生成素抑制剂活性并不高于对照组。总之，慢性肾病中红细胞生成相对不足似乎主要是由于促红细胞生成素产生减少，而非骨髓对促红细胞生成素的反应减弱。
