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3H-thymidine incorporation into normoblasts, proliferation rate of erythroid precursors and degree of intramarrow hemolysis have been studied in vitro on the bone marrow. The normal proliferation rate of normoblasts is 26 +/- 2% i.e. during 24 hours about a quarter of dividable elements of erythropoiesis is renewed. Acute blood loss increases the proliferation rate up to 57 +/- 9% but the value of 3H-thymidine incorporation into cells is not changed as compared to normal. In chronic blood loss both 3H-thymidine incorporation into dividing erythroid precursors at different stages of maturity and the rate of erythroid production are 2 to 3 times lower than normal. In healthy persons the degree of intramarrow hemolysis is 7 +/- 2% of erythroid precursors incubated for 24 hours. In iron deficiency anemia intramarrow destruction sharply increases, presenting at an average 30% of incubated nucleated elements of erythropoiesis. A type of chronic iron deficiency, which is not associated with blood loss, is described. In this type of anemia the proliferation rate of normoblasts and the degree of intramarrow hemolysis do not differ from normal values.

In 600 patients suffering from chronic renal insufficiency the cellularity of bone marrow, erythroid cells proliferative activity, erythroid cells destruction and iron incorporation rate, data of ferrokinetics, intracellular iron distribution, porphyrin synthesis rate were examined. On the basis of the obtained data the suggestion is put forward that metabolic disturbances are important in anemia development in uremic patients. One of the aspects of this problem is the role of disorders in the protein turnover causing changes in the synthesis of globin and porphyrin which are the primary components for heme synthesis. Special importance is attached to the changes in iron turnover, i.e. to its redistribution between stromal and heme pools.