Chronic renal failure (CRF) patients are accompanied by varying degrees of anemia, and with the decline of renal function, anemia gradually increased. CRF complicated by the pathogenesis of anemia have the following aspects:
Erythropoietin reduction: erythropoietin is mainly produced by glomerular glomerular cells and medulla stromal cells. CRF, in addition to the kidneys produce erythropoietin site damage, the hemoglobin on the oxygen affinity decreased, the unit hemoglobin on the oxygen utilization increased, renal ischemia is relatively serious, resulting in erythropoietin to stimulate the main stimulus, resulting in erythropoiesis The production of a significant reduction.
Toxins inhibit bone marrow: CRF when the accumulation of certain toxic substances in the blood marrow has a direct inhibitory effect, causing hematopoietic dysfunction.
Iron power disorder: iron storage and reticuloendothelial system metabolic abnormalities, hemoglobin metabolism out of the release of iron is affected, the result is serum iron down and supply of bone marrow iron reduction, affecting hematopoiesis.
Folic acid deficiency: CRF due to lack of intake often cause folic acid deficiency. In addition, uremic patients with folate-binding protein increased, can be transferred to the cell to reduce the number of folic acid. Long-term dialysis patients are more likely to produce folic acid deficiency.
Erythrocyte metabolic disorders and erythrocyte brittleness increased, resulting in erythrocyte autolysis; microvascular disease to red blood cells by mechanical damage and damage; erythrocyte metabolic disorders and erythrocyte brittleness increased; Spleen hyperthyroidism.
Red blood cell loss increased: chronic long-term upper gastrointestinal or lower digestive tract recessive bleeding, laboratory blood tests or residual blood loss in the dialyzer, can increase anemia.
The life of erythrocytes is shortened by the effects of retention of metabolites. Renal failure when the coagulation dysfunction, patients often bleeding tendency, such as epistaxis, bleeding gums, gastrointestinal bleeding, after more than so, blood loss increased anemia.