Red Blood Cell Osmotic Fragility in Chronically Hemodialyzed Patients

Abstract

Chronic renal failure induces anemia and a short erythrocyte life span. Red blood cell (RBC) osmotic fragility is the resistance of RBC hemolysis to osmotic changes that is used to evaluate RBC friability. To find the cause of shortened red cell survival in uremic patients, we evaluated the RBC osmotic fragility in 57 chronic hemodialyzed patients. Each patient had received 12 h of dialysis per week continuously prior to being enrolled in the study. Nineteen healthy volunteers served as a control group. Biochemistry, hemoglobin, electrolyte, osmolarity, β₂-microglobulin, and intact parathyroid hormone were examined before and after the dialysis session. To evaluate the osmotic fragility of RBC, blood samples were collected in heparinized test tubes. Fifty microliters of the RBC of each individual was then incubated in solutions containing a series of various concentrations of NaCl ranging from 0 to 0.6%. The concentration of NaCl at which 50% of RBCs were lysed was considered the median osmotic fragility (MOF). The results showed that the MOF was significantly greater in hemodialyzed patients before dialysis than in the control group (0.41 ± 0.03 vs. 0.39 ± 0.02%). The osmotic resistance to hemolysis was also recorded after dialysis (MOF 0.38 ± 0.03%). Correlation analysis showed that the MOF was significantly correlated with urea nitrogen, serum osmolarity, and intact parathyroid hormone level. In addition, the osmotic fragility was higher in patients who had a predialysis intact parathyroid hormone level >100 pg/dl. In conclusion, hemodialysis can improve the osmotic fragility. The mechanism underlying this improvement may be the removal of low molecular weight uremic toxins, resulting in normalization of serum osmolarity. Our results indicate that parathyroid hormone is probably a major factor influencing RBC osmotic fragility in chronic renal failure.

Osmotic Stress-induced Phosphorylation of H2AX by Polo-like Kinase 3 Affects Cell Cycle Progression in Human Corneal Epithelial Cells

“…Changes of the extracellular osmotic pressure are often found in some pathologic conditions, such as diabetes mellitus, uremia, dehydration after exercise, heat shock, fatal burns, and inflammation sites in various tissues including the cornea (1)(2)(3)(4). It has been shown that persistent hyperosmotic stress can induce DNA damage, cell cycle arrest, and apoptosis (5,6).…”

“…Hyperosmotic stress as one of the extracellular stimuli induces a series of changes in intracellular kinase cascades that include activation of JNK, p38, and Polo-like kinase 3 (Plk3) 2 signaling pathways to activate the important AP-1 (activating protein-1) transcription factor complex (11, 14 -18). Particularly, Plk3, one of the four members in the Polo like kinase family, plays a significant role in hyperosmotic stress-induced signaling cascades in addition to the JNK signaling pathway to transmit the stress signals in corneal epithelial cells.…”

Cellular effects of an aqueous solution of Losartan® on the survival of Escherichia coli AB1157 in the presence and absence of SnCl2, and on the physiological property (osmotic fragility) of the erytrocyte

“…The results obtained with the quality comparison of the shape of the RBC (non treated and treated with natural extracts) under optical microscopy could justify the modifications in the uptake of 99 mTc for the red blood cells in the presence of Mentha crispa extract, similar to that observed with the extract of Maytenus iliciofolia [ [18][19][20][21][22].…”

Neutrophil Activation and Erythrocyte Membrane Protein Composition in Stage 5 Chronic Kidney Disease Patients

“…In literature, there are few reports about the effect of CKD and haemodialysis procedure in erythrocyte membrane protein composition (Matos, 1997;Wu, 1998;Ibrahim, 2002). Studies performed in erythrocytes from stage 5 CKD patients, using cuprophane and polyacrylonitrile dialysis membranes, showed some changes in the membrane proteins, namely, a reduction in spectrin and band 3, and an isolated reduction in band 3, respectively (Sevilhano, 1990;Delmas-Beauvieux, 1995).…”

“…Studies performed in erythrocytes from stage 5 CKD patients, using cuprophane and polyacrylonitrile dialysis membranes, showed some changes in the membrane proteins, namely, a reduction in spectrin and band 3, and an isolated reduction in band 3, respectively (Sevilhano, 1990;Delmas-Beauvieux, 1995). Wu et al (Wu, 1998) and Ibrahim et al (2002) showed that stage 5 CKD patients presented a median osmotic fragility higher than the controls, and, after the haemodialysis procedure, that osmotic fragility decreased.…”