Bone Marrow Morphology in Patients on Regular Haemodialysis Treatment

Blood eosinophils were counted by the counting-chamber method in21 regular hemodialysis patients. Before dialysis, eosinophil counts were within the normal range in all patients (mean 98 cells/mm3, range 6–350). After the first 15 min of hemodialysis, with not reused coils or hollow-fiber dialysers, a significant drop in eosinophil counts was noted in all patients. The mean drop was 37.5% of the initial value (range 28–100%). At the end of the 5-hour dialysis, the eosinophil counts rose significantly in all patients but 1. The mean rise was 521 % of the initial counts (range 22.3–1576%). Simultaneous neutrophil counts showed the already described drop at 15 min with a return to predialysis levels at 5 h. Predialysis IgE serum concentrations were lower than normal (mean 24.8, range 4.5–58 units/ml), and did not change at the end of the dialysis. It seems that pulmonary sequestration is responsible for both neutropenia and eosinopenia early in dialysis. The marked eosinophilia at 5 h may be the result of a release of eosinophilotactic substances induced by the dialysis procedure itself.

Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Dialysis-Induced Eosinophilia

Bodner¹,

Peer²,

Zakuth³

et al. 1982

“…The blood contains only a small fraction of the total number of eosinophils in the body, and elevated circulating levels of ECP in the absence of peripheral eosinophilia may therefore reflect an increased total eosinophil mass located in other tissues than blood. As a matter of fact, previous studies have demonstrated a strong relationship between uremia and marrow eosino philia, albeit normal blood eosinophil counts [3,17]. The nature of the stimuli resulting in marrow eosinophilia is unknown.…”

Section: Discussionmentioning

confidence: 98%

Elevated Circulating Levels of Eosinophil Cationic Protein in Uremia as Signs of Abnormal Eosinophil Homeostasis

Hällgren¹,

Grefberg²

1984

Circulating levels of eosinophil cationic protein (ECP), an eosinophil-specific granule protein, and peripheral eosinophils were determined in 56 patients with uremia. The patients were on a chronic hemodialysis or CAPD program or treated with diet only. They had normal counts of peripheral eosinophils but on average a threefold increase of the serum ECP concentrations compared with healthy subjects. The intracellular content of ECP in eosinophils isolated from 6 patients on maintenance hemodialysis was normal. The management or duration of the uremic condition did not influence the circulating ECP levels or eosinophil counts. Neither was any relation found between total IgE levels and peripheral eosinophils or serum ECP. The present results are compatible with an accelerated turnover of peripheral eosinophils in uremia. Such a proposed abnormal eosinophil homeostasis should demand an accelerated marrow eosinophil production, thereby explaining the previously reported marrow eosinophilia in azotemic patients.

“…The rebound leuko cytosis that occurs following the acute leukopenia has been shown to be partly due to the release of neutrophils from the bone marrow [3,27]. These newly released neu trophils also show decreased adherence [25], Although there has been no demonstration that these laboratory studies of WBC function have adverse clinical correlates, it is well known that granulocyte adherence, chemotactic and phagocytic activities are essential mech anisms in the complex process for combating infection [28,29].…”

Section: Discussionmentioning

confidence: 99%

Hemodialysis-Associated Neutropenia and Hypoxemia: The Effect of Dialyzer Membrane Materials

Hakim

Lowrie²

1982

The fall in white blood cells (WBC) and arterial oxygen pressure that occurs during hemodialysis was investigated as a function of different dialysis membranes and different sterilization methods. 8 chronic hemodialysis patients were studied and each was dialyzed with three different membranes: cellulosic hollow fiber, polyacrylonitrile flat sheet and polymethylmethacrylate hollow fiber. Each dialyzer was studied with a dry sterilization method and after formalin treatment. Arterialized blood gas, bicarbonate and WBC were drawn at various intervals throughout dialysis. The effect of the sterilization method was minimal. Cellulosic membranes were shown to cause significantly more neutropenia (p < 0.001) and hypoxemia (p < 0.0l) than the other two membranes. No significant differences was seen in pH, PCO₂ and bicarbonate. The results indicate differences in biocompatibility between different membranes. Clinical implications are discussed.