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Red‐Cell Organic Phosphates in Patients with Chronic Renal Failure on Maintenance Haemodialysis
Author(s) -
Chillar R. K.,
Desforges Jane F.
Publication year - 1974
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/j.1365-2141.1974.tb00499.x
Subject(s) - chronic renal failure , red cell , diphosphoglycerate , dialysis , medicine , adenosine triphosphate , chemistry , endocrinology , hemoglobin
S ummary . The red cells of 17 patients with chronic renal failure and anaemia were studied after a mean duration of 4 hr haemodialysis; red‐cell 2, 3‐diphosphoglycerate (DPG) showed a significant fall whereas red‐cell adenosine triphosphate (ATP) remained unchanged. During the same period arterial blood pH showed a significant rise and in 10 out of 17 instances, reached frankly alkalotic values (> 7.45). Serum inorganic phosphate (P i ) fell by 40% during this time and may have been a factor in the fall of 2, 3‐DPG. This fall in 2, 3‐DPG in red cells was more pronounced in four patients who were given transfusions of banked blood during the haemodialysis period. There was no correlation between 2, 3‐DPG and arterial blood pH or between ATP and pH. There was no correlation between the degree of change of 2, 3‐DPG and the predialysis serum P i or the degree of change, although the mean value of both declined after dialysis. Similarly, no correlation was observed between ATP and predialysis P i . Constantly occurring complex biochemical alterations may be limiting factors responsible for this lack of expected relationship between these measurements. These changes might result in decreased oxygen delivery to tissues in uraemic patients since the haemoglobin oxygen affinity may be increased after haemodialysis by the dual effect of a fall in red‐cell 2, 3‐DPG and an increase in blood pH.