Recharging Red Blood Cell Surface by Hemodialysis

Kliche, Katrin; Gerth, Ulrich; Pavenstädt, Hermann; Oberleithner, Hans

doi:10.1159/000373936

Cited by 7 publications

(5 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In vitro , any increase beyond 140 mM Na + stiffens endothelial cells accompanied by a decrease of nitric oxide release (Oberleithner et al, 2007 ). In vivo , plasma Na + in the high physiological range is accompanied by elevated blood pressure (He et al, 2005 ; Suckling et al, 2013 ; Kliche et al, 2015 ), an observation that supports the in vitro results (Oberleithner et al, 2007 ). Since sustained elevated blood pressure affects the morphology of blood vessels, it is assumed to also affect RBC-EC adhesion.…”

Section: Discussionmentioning

confidence: 69%

Sodium renders endothelial cells sticky for red blood cells

2015

Self Cite

View full text Add to dashboard Cite

Negative charges in the glycocalyx of red blood cells (RBC) and vascular endothelial cells (EC) facilitate frictionless blood flow through blood vessels. Na+ selectively shields these charges controlling surface electronegativity. The question was addressed whether the ambient Na+ concentration controls RBC-EC interaction. Using atomic force microscopy (AFM) adhesion forces between RBC and endothelial glycocalyx were quantified. A single RBC, mounted on an AFM cantilever, was brought in physical contact with the endothelial surface and then pulled off. Adhesion forces were quantified (i) after enzymatic removal of negative charges in the glycocalyx, (ii) under different ambient Na+ and (iii) after applying the intracellular aldosterone receptor antagonist spironolactone. Removal of negative surface charges increases RBC-EC interaction forces. A stepwise increase of ambient Na+ from 133 to 140 mM does not affect them. However, beyond 140 mM Na+ adhesion forces increase sharply (10% increase of adhesion force per 1 mM increase of Na+). Spironolactone prevents this response. It is concluded that negative charges reduce adhesion between RBC and EC. Ambient Na+ concentration determines the availability of free negative charges. Na+ concentrations in the low physiological range (below 140 mM) allow sufficient amounts of vacant negative charges so that adhesion of RBC to the endothelial surface is small. In contrast, Na+ in the high physiological range (beyond 140 mM) saturates the remaining negative surface charges thus increasing adhesion. Aldosterone receptor blockade by spironolactone prevents Na+ induced RBC adhesion to the endothelial glycocalyx. Extrapolation of in vitro experiments to in vivo conditions leads to the hypothesis that high sodium intake is likely to increase the incidence of thrombotic events.

show abstract

Section: Discussionmentioning

confidence: 69%

Sodium renders endothelial cells sticky for red blood cells

2015

Self Cite

View full text Add to dashboard Cite

show abstract

“…Kliche et al . found that the RBC cell surface properties could be partially restored through the dialysis treatment, especially in those individuals with high serum sodium concentrations before the treatment [47]. It has been shown in vitro that sodium concentrations higher than 140 mmol/L impair the glycocalyx and increase adherence of erythrocytes to endothelial cells [48].…”

Section: Discussionmentioning

confidence: 99%

Erythrocyte Sodium Sensitivity and Eryptosis in Chronic Hemodialysis Patients

Meyring-Wösten

Kuntsevich

Campos

et al. 2017

Kidney Blood Press Res

View full text Add to dashboard Cite

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.

show abstract

“…Another study, carried out with the blood of dialysis patients, showed that the RBC glycocalyx is improved after acute hemodialysis, i.e. salt sensitivity decreases or, in other words, the Na + buffering power of the glycocalyx recovers by a 4-hour hemodialysis of patients suffering from chronic kidney disease [28].…”

Section: Discussionmentioning

confidence: 99%

Salt Sensitivity Determined From Capillary Blood

Oberleithner

Wilhelmi²

2016

Kidney Blood Press Res

Self Cite

View full text Add to dashboard Cite

Background/Aims: A significant rise of blood pressure in response to a given salt load is a weak indication of high salt sensitivity, supposed to foster the development of arterial hypertension and related diseases in later life. In search of an alternative method we recently developed the salt blood test (SBT), a new concept for quantifying salt sensitivity (SS). Based on this concept, namely that red blood cells (RBC) report on salt sensitivity, the SBT-mini was developed. Methods: The SBT-mini utilizes a droplet of capillary blood mixed with a ‘smart' Na⁺ cocktail. Red blood cells (RBC) of this mixture are allowed to sediment by gravity in a glass tube. SS is quantified by measuring RBC sedimentation rate. 90 healthy volunteers (39 males, 51 females; mean age: 23±0.5 years) were evaluated and ‘standard values' for males and females were derived. Results: Sodium buffer capacity of female blood is about 20 % smaller as compared to male blood due to the lower hematocrit of females. SS of an individual is related to the mean standard value (set to 100 %) of the respective male/female cohort. High SS (> 120 %) has been found in 31 % of males and 28 % of females. Conclusions: SS can be estimated derived from the individual RBC sodium buffer capacity as measured by the SBT-mini. About one third of a healthy test cohort exhibits a high sensitivity to salt. Reduction of sodium consumption to at least two grams per day (equals five grams of NaCl per day as suggested by the WHO) is recommended, particularly for individuals with high salt sensitivity.

show abstract

Recharging Red Blood Cell Surface by Hemodialysis

Cited by 7 publications

References 31 publications

Sodium renders endothelial cells sticky for red blood cells

Sodium renders endothelial cells sticky for red blood cells

Erythrocyte Sodium Sensitivity and Eryptosis in Chronic Hemodialysis Patients

Salt Sensitivity Determined From Capillary Blood

Contact Info

Product

Resources

About