RT Journal
A1 Lubin A, Ghose M
T1 CYtopenia in patients receiving dialysis
JF Archives of Internal Medicine
JO Archives of Internal Medicine
YR 1979
FD November 1
VO 139
IS 11
SP 1316
OP 1317
DO 10.1001/archinte.1979.03630480088030
UL http://dx.doi.org/10.1001/archinte.1979.03630480088030
AB To the Editor.— 
    The interesting study by Zingraff et al on anemic hemodialysis patients (Archives 138:1650-1652, 1978) further corroborates our hypothesis that renal bone disease contributes to cytopenia by mechanical marrow replacement, which we postulated was due not only to marrow fibrosis but also to bony sclerosis.1 We also observed more severe parathyroid bone disease in our patients with the most severe cytopenia when compared to our uremic anemic controls. This is shown by more extensive disease in bone surveys, and higher levels of serum alkaline phosphatase and immunoreactive parathyroid hormone determinations. In addition, Zingraff et al demonstrated increased hematocrit levels in several patients after parathyroidectomy, an exciting finding.However, thrombocytopenia and leukopenia are also found in populations subjected to long-term dialysis2 and sometimes all cases of cytopenia improve after splenectomy.3 We observed some patients with diminished RBC survival and evidence of splenic RBC sequestration, and proposed