[The hemodiafiltration with endogenous reinfusion reduces the erythroid progenitor inhibition by uremic serum].
OBJECTIVE
Anemia in end-stage renal disease (ESRD) patients shows a lower proliferation of erythroid progenitor cells such as burst forming unit-erythroid (BFU-E) than in normal subjects. As on-line hemodiafiltration with endogenous reinfusion(HFR) is thought to have a better biocompatibility and a wide range of uremic toxin removal, we compared the effect of serum obtained pre- and post-standard hemodialysis (HD) and HFR dialysis performed in four ESRD patients with proliferation in normal subject) (controls) bone marrow BFU-E.


METHODS
Mononuclear fraction was obtained by Ficoll-Hypaque density centrifugation and studies were performed in three different conditions: standard culture, adding serum from controls, adding serum from ESRD patients pre- and post HD and HFR dialysis. BFU-E were counted after 14 days with an inverted microscope and expressed as average scores from two dishes. Standardization between experiments was checked with a control culture for each experimental culture.


RESULTS
The BFU-E proliferation rate was clearly reduced by adding serum from ESRD patients either pre-HD or pre-HFR. However, while this inhibition was exacerbated by post-HD serum, it showed a significant reduction with post-HFR serum.


CONCLUSIONS
This effect could be due to the removal of uremic toxins or to a lower dialysis-induced cytokine release, both mechanisms involved in erythropoiesis inhibition in ESRD.
Aucella
F
F
U.O. di Nefrologia e Dialisi, Ospedale Casa Sollievo della Sofferenza IRCCS, San Giovanni Rotondo, Foggia. faucel@tin.it
Scalzulli
R P
RP
Vigilante
M
M
Stallone
C
C
D001790:Blood Physiological Phenomena; D002478:Cells, Cultured; D015672:Erythroid Precursor Cells / Q000502:physiology*; D017583:Hemodiafiltration / Q000379:methods*; D015312:Hemodialysis Solutions / Q000008:administration & dosage*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy*; D008875:Middle Aged; D014511:Uremia / Q000209:etiology / Q000628:therapy
D015312:Hemodialysis Solutions