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Diego Brancaccio, MD; Maurizio Gallieni, MD; Adriana Anelli, MD; Paola Padovese, MD
Milan, Italy

Arch Intern Med. 1988;148(10):2299-2302.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—We read with interest the article by Crowley and coworkers¹ describing the results of a retrospective study on the transfusion practice of a large renal hemodialysis center. We believe that the nephrologist's major concern is the more intensely transfused patients who, although a minority, require the majority of transfusions (67%, in that study).¹

We all look forward to the introduction in clinical practice of recombinant human erythropoietin, which will help our patients' bone marrow performance, but we must not forget that erythropoietin deficiency is not the only cause of anemia in hemodialysis patients, especialy intensely transfused ones. Crowley et al¹ do not mention a widely accepted cause of dialysis anemia: aluminum intoxication.^2,3 Assuming good control of aluminum levels in the dialysate, aluminum intoxication may occur in patients taking aluminum-containing gels to control hyperphosphatemia.⁴ The anemia caused by aluminum poisoning is non— iron-deficient, . . . [Full Text PDF of this Article]

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