[Anemia of kidney failure treated by periodical hemodialysis. III. The effect of splenectomy. A retrospective study of 25 cases].
Twenty-five patients with severe renal impairment treated by periodical haemodialysis underwent splenectomy (for spleen injury or tuberculosis in 2). All have been on long-term follow-up. At present, 7 patients have not improved; 7 are no longer transfused but remain anaemic with a less than 20% haematocrit; 11 have a more than 20% haematocrit without transfusion. Statistical analysis of the data shows that splenectomy, when effective, acts by reducing excess plasma volume and excessive haemolysis. Red cell production is not increased. The beneficial effect of splenectomy cannot be predicted from age, sex, cause of renal impairment or severity of anaemia. However, in this series there was a positive correlation between the degree of haemolysis, the site of red cell sequestration, the size of the spleen and the effectiveness of splenectomy. Infection, notably septicaemia in grafted (and immunodepressed) patients is a major risk of splenectomy and requires preventive measures.
D000740:Anemia / Q000209:etiology / Q000601:surgery*; D005069:Evaluation Studies as Topic; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D011379:Prognosis; D006435:Renal Dialysis; D012189:Retrospective Studies; D013156:Splenectomy
Anémie de l'insuffisance rénale traitée par hémodialyse périodique. III - Effet de la splénectomie. Etude rétrospective de 25 cas.