Does the extracorporeal circulation worsen anemia in hemodialysis patients? Investigation with advanced microscopes of red blood cells drawn at the beginning and end of dialysis

Σταμόπουλος, Δ.; Bakirtzi, Nerantzoula; Manios, E.; Grapsa, Eirini

doi:10.2147/ijn.s49845

Cited by 4 publications

(3 citation statements)

References 26 publications

(38 reference statements)

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“…Technical improvements of the dialysis equipment reduced the mechanical stress of the process itself on erythrocytes and erythrocyte lifetime increased [58]. In our population HD patients did not have a significantly higher percentage of eryptotic RBCs as determined by annexin V binding to PS-exposing erythrocytes.…”

Section: Discussionmentioning

confidence: 64%

Erythrocyte Sodium Sensitivity and Eryptosis in Chronic Hemodialysis Patients

Meyring-Wösten

Kuntsevich

Campos

et al. 2017

Kidney Blood Press Res

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Background/Aims: In hemodialysis (HD) patients the endothelial and erythrocyte glycocalyx is impaired which in turn correlates with elevated erythrocyte sodium sensitivity (ESS). Additionally, apoptotic erythrocyte death (eryptosis), characterized by phosphatidylserine (PS) exposure on the cell surface, is increased in this population. We aimed to explore the relationship of ESS and eryptosis. Methods: Blood samples were collected from 11 healthy controls and 20 chronic HD patients before and after midweek HD. ESS was quantified by the salt blood test. PS-exposure, intracellular reactive oxygen species (ROS) of erythrocytes and reticulocytes were assessed by flow cytometry. Results: Compared to controls ESS was significantly higher in HD patients preHD and did not change during treatment. The percentage of eryptotic cells did not differ between controls and patients preHD. However, eryptosis decreased during HD. ESS and eryptosis were uncorrelated, while eryptosis was positively correlated with intracellular ROS and percent reticulocytes. Conclusions: Higher ESS levels in HD patients indicate a pathologic glycocalyx. ESS and eryptosis were not correlated. The decreased eryptosis postHD may possibly be related to dialytic uremic toxin removal, but is likely multifactorial. The relationship between eryptosis and intracellular ROS warrants further research.

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Section: Discussionmentioning

confidence: 64%

Erythrocyte Sodium Sensitivity and Eryptosis in Chronic Hemodialysis Patients

Meyring-Wösten

Kuntsevich

Campos

et al. 2017

Kidney Blood Press Res

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“…In the early days of hemodialysis mechanical destruction of erythrocytes during frequent hemodialysis was thought to be a major cause for anemia observed in these patients [7,8,9,10,11,12,13,14,15,16,17,18]. Along with the technical improvement of the dialysis equipment the adverse (mechanical) influence of the dialysis process by itself on erythrocyte survival became less [19,20]. Today, anemia in CKD patients is mainly explained by reduced erythropoiesis and the presence of uremic toxins which trigger early eryptosis [21].…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, RBC show early senescence in CKD patients [6,19,31] and the question was raised whether frequent hemodialysis contributes (positively or negatively) to this process.…”

Section: Discussionmentioning

confidence: 99%

Recharging Red Blood Cell Surface by Hemodialysis

Kliche

Gerth

Pavenstädt

et al. 2015

Cell Physiol Biochem

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Background: Similar as in vascular endothelium the negatively charged glycocalyx of erythrocytes selectively buffers sodium. Loss of glycocalyx (i.e. loss of negative charges) leads to increased erythrocyte sodium sensitivity (ESS) quantified by a recently developed salt-blood-test (SBT). The hypothesis was tested whether a regular 4-hour hemodialysis (4h-HD) alters ESS. Methods:In 38 patients with end stage renal disease (ESRD) ESS was measured before and after 4h-HD, together with standard laboratory and clinical parameters (electrolytes, acid-base status, urea, creatinine, hemoglobin, c-reactive protein and blood pressure). Results: Before 4h-HD, 20 patients (out of 38) were classified as “salt sensitive” by SBT. After 4h-HD, this number decreased to 11. Erythrocyte sodium buffering power remained virtually constant in patients with already low ESS before dialysis, whereas in patients with high ESS, 4h-HD improved the initially poor sodium buffering power by about 20%. No significant correlations could be detected between standard blood parameters and the respective ESS values except for plasma sodium concentration which was found increased by 3.1 mM in patients with high salt sensitivity. Conclusions: 4h-HD apparently recharges “run-down” erythrocytes and thus restores erythrocyte sodium buffering capacity. Besides the advantage of efficient sodium buffering in blood, erythrocytes with sufficient amounts of free negative charges at the erythrocyte surface will cause less (mechanical) injury to the negatively charged endothelial surface due to efficient repulsive forces between blood and vessel wall. Hemodialysis improves erythrocyte surface properties and thus may prevent early vascular damage in patients suffering from ESRD.

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Acute Complications of Hemodialysis

Bowman¹,

Rosner²

2019

Chronic Kidney Disease, Dialysis, and Transplantation

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Does the extracorporeal circulation worsen anemia in hemodialysis patients? Investigation with advanced microscopes of red blood cells drawn at the beginning and end of dialysis

Cited by 4 publications

References 26 publications

Erythrocyte Sodium Sensitivity and Eryptosis in Chronic Hemodialysis Patients

Erythrocyte Sodium Sensitivity and Eryptosis in Chronic Hemodialysis Patients

Recharging Red Blood Cell Surface by Hemodialysis

Acute Complications of Hemodialysis

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