Red blood cell volume is not decreased in ESA ‐naive anemic chronic kidney disease patients

Hemoglobin concentration (g/L; black circles), deviation (%) from idealized plasma volume (PV (%); white bars) and deviation (%) from idealized red blood cell volume (RBCV (%); grey bars) in non ‐anemic (left from vertical dotted line) and anemic (right from vertical dotted line) CKD male patients. This figure illustrates the fact that most patients with anemia in predialysis CKD have an increase in plasma volume and a relatively normal RBCV, supporting the fact that anemia of CKD may oft en be dilutional. AbstractAnemia is defined according to decreased blood hemoglobin concentration ([Hb]), which is considered a marker of low total red blood cell volume (RBCV). Alterations of plasma volume (PV) may also modify [Hb] without concomitant changes in RBCV. Since anemia and fluid retention are frequent complications of chronic kidney disease (CKD), we hypothesized that anemia during CKD may in part be related to expanded PV without a simultaneous decrease in RBCV. We quantified hemoglobin mass, RBCV, PV, and total blood volume (BV) using an automated carbon monoxide device in 40 consecutive stage 3 –5 CKD patients not on dialysis and in seven healthy male controls of the same age range. These were compared within and to predicted volumes according to Nadler's formula. Arterial stiffness and NT‐proBNP were measured. RBCV was similar to predicted values range in anemic CKD patients 2073 (181 8–2704) versus, 2061 (1725–2473) mL,P >  0.05. In contrast, PV was largely i...
Source: Physiological Reports - Category: Physiology Authors: Tags: Original Research Source Type: research