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Neil Shusterman, MD; Paul L. Kimmel, MD; Frederick L. Kiechle, MD, PhD; Susan Williams, MD; Gail Morrison, MD; Irwin Singer, MD

Arch Intern Med. 1985;145(10):1796-1799.

Abstract
• Erythrocyte sedimentation was studied in stable patients with chronic renal failure free of complicating illnesses. The mean (±SD) Westergren erythrocyte sedimentation rate was 49±26 mm/hr in patients not receiving dialysis and 60±33 mm/hr in patients receiving hemodialysis. Both values are significantly higher than normal. Because anemia accelerates the Westergren determination, we restudied the patients with the zeta sedimentation ratio (ZSR), a method unaffected by hematocrit. In nine patients not receiving dialysis and 49 patients receiving hemodialysis, the ZSR was significantly higher than normal. The ZSR correlated positively with plasma fibrinogen concentration. Recombination experiments showed that the abnormal factor accelerating erythrocyte sedimentation was a constituent of plasma. Thus, erythrocyte sedimentation is accelerated in stable patients with chronic renal failure and a plasma factor, probably fibrinogen, is responsible. An elevated erythrocyte sedimentation rate in this population lacks diagnostic usefulness.

(Arch Intern Med 1985;145:1796-1799)

Author Affiliations
From the Renal-Electrolyte Section (Drs Shusterman, Kimmel, Williams, Morrison, and Singer) and the Division of Laboratory Medicine (Dr Kiechle), University of Pennsylvania School of Medicine, Philadelphia.

Footnotes
Accepted for publication Jan 2, 1985.

Read in part at the 16th Annual Meeting of the American Society of Nephrology, Washington, DC, Dec 4, 1983.

Reprint requests to Renal-Electrolyte Section, 860 Gates Bldg, 3400 Spruce St, Philadelphia, PA 19104 (Dr Shusterman).

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