Abstract
Ten patients undergoing chronic hemodialysis for end-stage renal disease were studied in order to determine the acute effects of hemodialysis on the metabolic function of the erythrocyte in anemic uremic patients. Prior to hemodialysis there was a mean red cell mass deficit of 148 g Hb/sq m. The affinity of hemoglobin for oxygen was decreased, and this was associated with an increase in intraerythrocytic levels of 2,3-DPG and ATP. The plasma phosphorus levels were also increased in the predialysis period. Following 5-6 hr of hemodialysis the affinity of hemoglobin for oxygen and the intraerythrocytic levels of 2,3-DPG were unchanged from the predialysis values despite a significant reduction in plasma phosphorus levels and a significant increase in both whole blood and intraerythrocytic pH.
From these data we conclude that the maintenance of the red cell’s decreased oxygen affinity resulted from the increase in intraerythrocytic pH which maintained the intraerythrocytic levels of 2,3-DPG despite a reduction in plasma phosphorus. The reduction in plasma phosphorus was primarily reflected in a decrease in red cell ATP.
