1. The oral absorption and the rate of loss from the body of radioactive iron were measured by whole-body monitoring in patients with functioning renal homografts. The incorporation of radioactive iron into erythrocytes was also measured. 2. The results were compared with corresponding values in normal subjects and in non-dialysed and dialysed patients with chronic renal failure. 3. The mean oral absorption and incorporation into erythrocytes of radioactive iron was intermediate between that of normal subjects and of both non-dialysed and dialysed patients with chronic renal failure. 4. The mean rate of loss from the body was not significantly different from that in normal subjects and non-dialysed patients with chronic renal failure but it was significantly less than that in dialysed patients.
1. By using a whole-body monitoring technique iron metabolism has been investigated in patients suffering from chronic renal failure who required regular dialysis treatment. 2. Oral absorption of inorganic iron was low. 3. The incorporation of radioactive iron into erythrocytes was diminished. 4. The rate of loss of radioactive iron from the body was significantly greater than in normal control and non-dialysed patients with chronic renal failure. 5. Iron exchange between dialysate and patient was studied. Patients with chronic renal failure are known to have a decreased rate of erythropoiesis and to develop abnormalities in iron metabolism (Kaye, 1958; Logue, Lange & Moore, 1958; Boddy, Lawson, Linton & Will, 1970). However, considerable controversy exists about the effect of haemodialysis on iron metabolism in such patients (Shaldon, 1966; Eschbach, Funk, Adamson, Kuhn, Scribner & Finch, 1967; Eschbach, Cook & Finch, 1970). The use of a whole-body monitor permitted measurement in a single study of the oral absorption of a tracer dose of 59 Fe, its incorporation into erythrocytes and the subsequent long-term rate of loss of 59 Fe from the body. We have previously reported the results of an investigation of iron metabolism by using this method in patients with chronic renal failure (Boddy et al. , 1970). We now report the results of a similar investigation of iron metabolism in patients with chronic renal failure undergoing regular haemodialysis therapy.
1. Iron metabolism has been investigated in patients suffering from chronic renal failure, using a whole body monitoring technique. 2. Absorption of labelled inorganic iron was decreased. 3. Radio-iron was lost from the body at a rate comparable to that found in normal subjects. 4. The red cell incorporation of radioactive iron was diminished. 5. The results suggest that anaemia in these patients was due to decreased erythropoiesis and not due to iron deficiency despite the evidence of markedly abnormal iron handling presented.
1. Water and electrolyte status in chronic renal failure has been measured by skeletal muscle biopsy. These results have been compared with a series of muscle biopsy specimens taken from the same muscle (vastus lateralis) of normal subjects. 2. The water content, especially of the extracellular phase, is increased in chronic renal failure: the extracellular sodium and chloride contents are also increased. These changes tend to be more marked as the severity of renal failure increases. 3. The intracellular water and potassium contents in chronic renal failure are little different from those in normal patients. 4. A significant correlation between diastolic blood pressure and extracellular water content is shown and this is especially marked in more severe degrees of renal impairment. 5. These results support the belief that hypertension in chronic renal failure is salt and water dependent, and that hypertension in these patients can be controlled by removal of salt and water.