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Oxygen Binding to Haemoglobin in Subjects with Hypoproliferative Anaemia, with and without Chronic Renal Disease: Role of pH
Author(s) -
Lichtman M. A.,
Murphy M. S.,
Whitbeck A. A.,
Kearney E. A.
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.tb06810.x
Subject(s) - diphosphoglycerate , bicarbonate , red cell , alkalosis , red blood cell , medicine , metabolic alkalosis , chemistry , hemoglobin , endocrinology , acidosis
S ummary . The relationships of haenioglobin concentration and blood pH to red cell 2,3‐dipliosphoglycerate and oxygen binding by haenioglobin have been studicd in healthy subjects and subjects with hypoproliferative anaemia with or without severe chronic renal disease. Red cell 2,3‐DPG was inversely correlated with haemoglobin deficit and directly and equally strongly associated with blood pH in anaemic subjects without chronic renal disease. In subjects with chronic renal disease receiving regular haemodialysis, predialysis pH was not increased despite severe anaemia, and red cell 2,3‐DPG was not significantly elevated, except in subjects who had a sustained alkalosis due to the use of sodium bicarbonate. In hypoproliferative anaemia, the incrcmcnt in pH was associated with the decrease in haenioglobin concentration such that 80% of the increase in p50 measured at standard conditions which occurred with anaemia was explicable by the relationship of (a) pH with haemoglobin concentration, (b) red cell 2,3‐DPG with pH, and (c) pso std with red cell 2,3‐DPG. However, p50 at the pH and base excess present in vivo was similar in all anaemic subjects whether an increase in red cell 2,3‐DPG occurred or not. Blood alkalosis and the accumulation of 2,3‐DPG cancelled each other's effect on oxygen binding by haemoglobin. Hence, increased red cell 2,3‐DPG and p50 compensated for the alkalosis of hypoproliferative anaemia, not for the deficit in haemoglobin concentration.