Renal Anaemia and Effectiveness of Long-term Dialysis

Overview

Renal anaemia causes in patients with chronic renal failure numerous serious problems which can be favourablyinfluenced by improvement of the anaemia. There is a number of known factors which cause deterioration of anaemiaand make its treatment more difficult. For a long time it was not clear that these negatively acting factors includedalso insufficiently effective dialysis treatment. The authors of the submitted paper evaluate the relationship betweenanaemia and the effectiveness of dialysis based on new data reported in the literature and their own results. Fromthis evaluation ensues that inadequate haemodialysis, assessed from the percentage reduction of urea in blood, isassociated with a reduced response to recombinant human erythropoietin which is the basic remedy of renal anaemia.If the inadequate intensity of haemodialysis is increased, anaemia improves substantially. In patients on continuousambulatory peritoneal dialysis (CAPD) there is a direct relationship between the effectiveness of blood purificationexpressed by the index KT/Vurea, i.e. the indicator of urea elimination, and the severity of anaemia. In patients treatedby CAPD there is a significant association between the haematocrit and KT/Vurea supplied by the peritoneum as wellas the kidneys. KT/Vurea supplied by the patient’s own kidneys is from the aspect of anaemia more significant. Somefacts regarding the relationship between anaemia and the effectiveness of dialysis treatment remain obscure so far.This however does not influence the fact that based on data available at present, effective dialysis must be includedamong basic prerequisites of effective treatment of renal anaemia in dialyzed patients.

Key words:
chronic renal failure, renal anaemia, haemodialysis, peritoneal dialysis, effectiveness, adequacy,erythropoietin.