[Renal anemia and the effect of long-term dialysis]

Renal anaemia causes in patients with chronic renal failure numerous serious problems which can be favourably influenced by improvement of the anaemia. There is a number of known factors which cause deterioration of anaemia and make its treatment more difficult. For a long time it was not clear that these negatively acting factors included also insufficiently effective dialysis treatment. The authors of the submitted paper evaluate the relationship between anaemia and the effectiveness of dialysis based on new data reported in the literature and their own results. From this evaluation ensues that inadequate haemodialysis, assessed from the percentage reduction of urea in blood, is associated 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 continuous ambulatory peritoneal dialysis (CAPD) there is a direct relationship between the effectiveness of blood purification expressed by the index KT/Vurea, i.e. the indicator of urea elimination, and the severity of anaemia. In patients treated by CAPD there is a significant association between the haematocrit and KT/Vurea supplied by the peritoneum as well as the kidneys. KT/Vurea supplied by the patient's own kidneys is from the aspect of anaemia more significant. Some facts 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 included among basic prerequisites of effective treatment of renal anaemia in dialyzed patients.