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Abnormal red cell metabolism in patients with chronic uremia: Nature of the
defect and its persistence despite adequate hemodialysis
Y Yawata and HS Jacob
A red cell metabolic abnormality, which diminishes the maximum activity of
the pentose phosphate shunt, occurs in some uremic patients, even those
adequately dialyzed with fluids prepared from distilled or
charcoal-filtered water. Within individual patients the severity of this
abnormality does not change even after 9 mo of consecutive hemodialyses.
However, between patients it does correlate inversely with hematocrit. When
erythrocytes from patients with the abnormality are stressed with oxidant
compounds, such as ascorbate, erythrocyte glucose consumption and lactate
formation are abnormally increased, while lactate/pyruvate ratios
abnormally diminish. Concomitantly, red cell glycolytic intermediates,
including fructose-1,6-diphosphate, glyceraldehyde-3-phosphate,
3-phosphoglycerate, phosphoenol pyruvate, and pyruvate, markedly
accumulate. Surprisingly, no increase of 2- phosphoglycerate occurs, which
suggests that inefficient phosphoglyceromutase activity underlies this
perturbation of erythrocyte metabolism and its associated hemolytic
process.
Volume 45,
Issue 2,
pp. 231-239,
02/01/1975
Copyright © 1975 by The American Society of Hematology
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