[Anemia syndrome in patients with chronic renal insufficiency on peritoneal dialysis treated with recombinant erythropoietin]. / Anemicheskii sindrom u bol'nykh khronicheskoi pochechnoi nedostatochnost'iu, nakhodiashchikhsia na peritoneal'nom dialize, pri lechenii rekombinantnym éritropoétinom.

The paper presents the results of the studies of erythrocytic and iron metabolism parameters in the course of treatment with recombinant erythropoietin (RE) and iron preparations in 60 patients with chronic renal failure (CRF) on peritoneal dialysis (PD) aged 20 to 75 years. Pretreatment iron deficiency in CRF patients on PD persisted to the end of the third observation period. Hyperferritinemia registered in CRF patients on PD with frequent peritonitis may be considered as a result of active ferritin synthesis by the cells of the system of mononuclear phagocytes in response to inflammation. The only parameter indicating the presence of iron deficiency seems to be the percentage of hypochrome erythrocytes indirectly evidencing for insufficient supply and iron utilization in bone marrow. Pathogenetic mechanisms of anemia development in CRF patients on PD may be both low EP and high levels of proinflammatory cytokines as well as oversecretion of ferritin by activated by monocytes/macrophages ferrin, promoting apoptosis of late erythropoiesis precursors, development of ineffective erythropoiesis and having a suppressive effect on erythropoiesis cell precursors.