Уремический синдром вызывает нарушение деформационно-функциональных характеристик эритроцитов у пациентов хронического гемодиализа

Abstract

End stage of chronic kidney disease (CKD-V) is associated with alterations in erythrocyte structure and functions which are the potential risk factors to interrupt erythrocyte proper activity however the mechanisms of such changes remain understudied. We used laser diffraction approach for investigation of CKD and hemodialysis (HD) effects on deformability of CKD-V patients red blood cells. HD did not affect red blood cell (RBCs) deformability however we showed two-stage alteration in renal patients’ RBCs deformability corresponding to the time of HD treatment or/and susceptibility to uremic syndrome. The first stage was characterized by increase in initial velocity of cell swelling (Vi) and decrease in the time to peak hemolysis rate (Tmax), and indicated the increase in RBCs fragility in patients receiving HD treatment up to 25 months (Group 1). The second stage outlined the decrease in Vi and increase in Tmax, that indicated the increase in rigidity of RBCs in patients receiving HD treatment from 25 months to 250 months (Group 2). In interdialytic periods the increase in concentration of uremic toxins (urea, uric acid) was detected, at the same time there were no changes in sodium and glucose concentrations. The increase in uremic toxins lead to osmolality accrual up to 330 mOsm/kg in patients of Group1 before HD, up to 340mOsm/kg in patients of Group 2 before HD. In summary, HD did not affect the functional parameters of RBCs, however our data clearly indicated the two-stage deformability alteration in renal patients’ RBCs that is triggered by uremic syndrome and potentially may lead to renal anemia and cardio-vascular complications specifically attributed to CKD-V patients.