Inhibitors of erythropoiesis found in the blood of uremic patients have been implicated as some of the causes of
anemia in
chronic renal failure. As a treatment to remove the inhibitors,
continuous ambulatory peritoneal dialysis (
CAPD) is thought to be more effective than
hemodialysis. Some researchers have reported that
CAPD has improved anemic state in
hemodialysis patients. However, there have been some cases of severe
anemia seen in
CAPD patients. To access the effect of the
CAPD, we have performed serial examination on
hemoglobin (Hb) and hematocrit (Ht) in 5 uremic patients under
CAPD treatment. Hb levels in 4 and Ht in 3 of 5 patients have been known to be increased. One patient was shown to have no increment on the levels of Hb and Ht. On the other hand, further investigation has been down to access the effect of the recombinant human
erythropoietin (r-HuEPO: Chugai pharmaceutical) on anemic patients, in whom no effect was noticed by treatment of
CAPD. One severe anemic patient, who had been undergoing the treatment of
CAPD for two years, was given r-HuEPO intravenously. The patient showed the increment on the levels of Hb and Ht, and the decreases on the levels of serum
iron and
ferritin. However, the patient has developed
hypertension. In conclusion,
CAPD was known to be not always effective for the increment of Hb and Ht, while r-HuEPO was very effective for the improvement of severe
anemia in
CAPD patients which enabls them to lead better social life for them.