Hematologic abnormalities in patients with renal diseases

Renal diseases are associated with a host of hematologic abnormalities affecting erythropoiesis, thrombopoiesis, platelet function, coagulation, fibrinolysis, and immune function. Many of the abnormalities described in acute or chronic renal failure appear to be directly related to accumulation of uremic toxins, particularly those in the middle molecular range and may respond to dialysis treatment. The recent availability of recombinant human erythropoietin facilitated the demonstration that anemia in renal failure is predominantly due to inadequate production of erythropoietin, and evolution in the management of anemia in these patients is now likely. Renal cell carcinoma is associated with a variety of unusual hematologic manifestations that may be confused with other diseases, but when recognized provide an early clue to the presence of a renal tumor and result in successful therapy.